Matthew S Fry, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D14076 Issued in MN

Practice address

431 Main St N Ste B
Chatfield, MN 55923-1172

Phone

(507) 867-3550

NPI assigned

Jun 28, 2018

Last updated

Jun 28, 2018By 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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Modern Dental Professionals MN PC

  dba Midwest Dental

  • Dentist
  • Chatfield, MN
  • NPI 1245413921
  NPD (past)

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

{
    "created_epoch": "1530144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530144000000",
    "number": "1477048759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 28TH ST SE APT 204",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559046849",
            "telephone_number": "620-757-3677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "431 MAIN ST N STE B",
            "city": "CHATFIELD",
            "state": "MN",
            "postal_code": "559231172",
            "telephone_number": "507-867-3550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRY",
        "first_name": "MATTHEW",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-06-28",
        "last_updated": "2018-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D14076",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Victoria L Dietz, MD
• Christopher Dornack, PHARMD
• Alyssa Eckdahl, RN
• Elder Chiropractic Offices LTD.
• Julie Kay Elder, D.C.
• Amber Jacobson
• McBe Company (Weber & Judd - Chatfield)
• Modern Dental Professionals MN PC (Midwest Dental)
• Kimberly Sue Moeller, LICSW, LADC
• Monarch Patient Transport, LLC

• General Practice Dentistry in Chatfield, MN
• Providers in Chatfield, MN by specialty
• General Practice Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2018; 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.