Active NPI
Fredrich Dengel, M.D.
- Diagnostic Radiology Physician
- Lorain, OH
National Provider Identifier
1477555233
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 35045581
- Practice address
- 1720 Cooper Foster Park Rd W
Suite B
Lorain, OH 44053-4200 - Phone
- (440) 989-4480
- Fax
- (440) 989-4484
- NPI assigned
- Aug 11, 2005
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 35045581 | OH | Primary |
Addresses
Primary practice location
1720 Cooper Foster Park Rd W
Suite B
Lorain, OH 44053-4200
Mailing address
1720 Cooper Foster Park Rd W
Suite B
Lorain, OH 44053-4200
Phone (440) 989-4480
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 553842 | Medicaid | OH |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35045581 | OH | MD | Diagnostic Radiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1123718400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1317945600000",
"number": "1477555233",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1720 COOPER FOSTER PARK RD W",
"address_2": "SUITE B",
"city": "LORAIN",
"state": "OH",
"postal_code": "440534200",
"telephone_number": "440-989-4480",
"fax_number": "440-989-4484"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1720 COOPER FOSTER PARK RD W",
"address_2": "SUITE B",
"city": "LORAIN",
"state": "OH",
"postal_code": "440534200",
"telephone_number": "440-989-4480",
"fax_number": "440-989-4484"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DENGEL",
"first_name": "FREDRICH",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-11",
"last_updated": "2011-10-07",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "OH",
"license": "35045581",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "553842",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lorain, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 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.