Samuel Jon Frydenlund, DDS

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

2901014864 Issued in MI

Practice address

2325 Shiawassee
Suite 101
Fenton, MI 48430-1792

Phone

(810) 732-3910

Fax

(810) 732-6836

NPI assigned

Sep 14, 2006

Sex

Male

Sole proprietor

No

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497850572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4007 WEST COURT ST",
            "address_2": "STE H",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485323560",
            "telephone_number": "810-732-3910",
            "fax_number": "810-732-6836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2325 SHIAWASSEE",
            "address_2": "SUITE 101",
            "city": "FENTON",
            "state": "MI",
            "postal_code": "484301792",
            "telephone_number": "810-732-3910",
            "fax_number": "810-732-6836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRYDENLUND",
        "first_name": "SAMUEL",
        "middle_name": "JON",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "MI",
            "license": "2901014864",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deborah A Fowler, P,A.-C
• Teresa Fowler
• Nora Laurel Francis, RPH, MBA
• Alan Fredendall, DPT
• Mackenzie Freeman
• Aileen Fullen
• Katherine Elizabeth Gallagher
• Kerri L Gallenbeck, LMT
• James S Garfield, DO
• Macey Garrido

• Orthodontics and Dentofacial Orthopedics Dentistry in Fenton, MI
• Providers in Fenton, MI by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.