Individual provider Active NPI

Fredric M. Weiss, DDS

  • Dentist
  • Suffern, NY
National Provider Identifier
1467721779
Registry record updated Dec 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
026688 Issued in NY
Practice address
5 Milford Lane
Suffern, NY 10901
Phone
(845) 357-5522
Fax
(845) 357-9598
NPI assigned
Dec 16, 2011
Last updated
Dec 16, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 026688 NY Primary

Addresses

Primary practice location

5 Milford Lane
Suffern, NY 10901

Mailing address

5 Milford Lane
Suffern, NY 10901
Phone (845) 357-5522

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

NPI Registry JSON

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

{
    "created_epoch": "1323993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323993600000",
    "number": "1467721779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 MILFORD LANE",
            "city": "SUFFERN",
            "state": "NY",
            "postal_code": "10901",
            "telephone_number": "845-357-5522",
            "fax_number": "845-357-9598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 MILFORD LANE",
            "city": "SUFFERN",
            "state": "NY",
            "postal_code": "10901",
            "telephone_number": "845-357-5522",
            "fax_number": "845-357-9598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEISS",
        "first_name": "FREDRIC",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-12-16",
        "last_updated": "2011-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "026688",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Suffern, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.