Active NPI
Randy Freij, DDS
- General Practice Dentistry
- Farmington Hills, MI
National Provider Identifier
1376612101
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 2901018929
- Practice address
- 31393 W 13 Mile Rd
Suite 100
Farmington Hills, MI 48334-2297 - Phone
- (734) 474-4703
- Fax
- (734) 522-0534
- NPI assigned
- Nov 7, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 2901018929 | MI | Primary |
Addresses
Primary practice location
31393 W 13 Mile Rd
Suite 100
Farmington Hills, MI 48334-2297
Mailing address
31393 W 13 Mile Rd
Suite 100
Farmington Hills, MI 48334-2297
Phone (734) 474-4703
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2901018929 | Other | MI | LICENSE NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2901018929 | MI | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Superior Family Dental | General Practice | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Practice Dentistry
- Farmington Hills, MI
- NPI 1891936340
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162857600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1233964800000",
"number": "1376612101",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "31393 W 13 MILE RD",
"address_2": "SUITE 100",
"city": "FARMINGTON HILLS",
"state": "MI",
"postal_code": "483342297",
"telephone_number": "734-474-4703",
"fax_number": "734-522-0534"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "31393 W 13 MILE RD",
"address_2": "SUITE 100",
"city": "FARMINGTON HILLS",
"state": "MI",
"postal_code": "483342297",
"telephone_number": "734-474-4703",
"fax_number": "734-522-0534"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FREIJ",
"first_name": "RANDY",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-07",
"last_updated": "2009-02-07",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MI",
"license": "2901018929",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE NUMBER",
"identifier": "2901018929",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Farmington Hills, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.