Individual provider Active NPI

Frederick L Bayon, DMD

  • Dentist
  • Worcester, MA
National Provider Identifier
1417023219
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
11221 Issued in MA
Practice address
445 Grove St
Worcester, MA 01605-1225
Phone
(508) 755-0372
Fax
(508) 754-2444
NPI assigned
Nov 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 11221 MA Primary

Addresses

Primary practice location

445 Grove St
Worcester, MA 01605-1225

Mailing address

445 Grove St
Worcester, MA 01605-1225
Phone (508) 755-0372

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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

Enrollment IDStateProvider typePAC IDDetails
I20160712001252 MA Order and Referring Only - DentistPractitioner - Dentist 4385936343

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11221MAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1164585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417023219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "445 GROVE ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016051225",
            "telephone_number": "508-755-0372",
            "fax_number": "508-754-2444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "445 GROVE ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016051225",
            "telephone_number": "508-755-0372",
            "fax_number": "508-754-2444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAYON",
        "first_name": "FREDERICK",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "11221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.