Active NPI
Jeremy M Frith, DDS
- Dentist
- Ellisville, MO
National Provider Identifier
1376978817
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 2013031444
- Practice address
- 269 Clarkson Rd
Ellisville, MO 63011-2219 - Phone
- (636) 394-5200
- NPI assigned
- Sep 3, 2013
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 2013031444 | MO | Primary |
Addresses
Primary practice location
269 Clarkson Rd
Ellisville, MO 63011-2219
Mailing address
269 Clarkson Rd
Ellisville, MO 63011-2219
Phone (636) 394-5200
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 |
|---|---|---|---|
| 2013031444 | MO | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Michael P Frith DDS | Past | Accepting new patients | |
| Jeremy M Frith DDS | Dentist | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Dentist
- Ellisville, MO
- NPI 1700213642
-
- General Practice Dentistry
- Ellisville, MO
- NPI 1760549380
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1378166400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1378252800000",
"number": "1376978817",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "269 CLARKSON RD",
"city": "ELLISVILLE",
"state": "MO",
"postal_code": "630112219",
"telephone_number": "636-394-5200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "269 CLARKSON RD",
"city": "ELLISVILLE",
"state": "MO",
"postal_code": "630112219",
"telephone_number": "636-394-5200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FRITH",
"first_name": "JEREMY",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-09-03",
"last_updated": "2013-09-04",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MO",
"license": "2013031444",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ellisville, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.