Jonathan Samuel Friedman, DMD

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

DS036841 Issued in PA

Practice address

14 S Bryn Mawr Ave
Bryn Mawr, PA 19010-3216

Phone

(610) 527-6061

NPI assigned

Nov 20, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376617456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 CONCORD CIR",
            "city": "BALA CYNWYD",
            "state": "PA",
            "postal_code": "190042607",
            "telephone_number": "484-433-0582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 S BRYN MAWR AVE",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190103216",
            "telephone_number": "610-527-6061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIEDMAN",
        "first_name": "JONATHAN",
        "middle_name": "SAMUEL",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "PA",
            "license": "DS036841",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Periodontics in Bryn Mawr, PA
• Providers in Bryn Mawr, PA by specialty
• Periodontics in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.