Individual provider Active NPI

Robert A Fremeau, DMD

  • Periodontics
  • Manchester, NH
National Provider Identifier
1588669477
Registry record updated Aug 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
02-0342066 Issued in NH
Practice address
30 Canton St
Ste 12
Manchester, NH 03103-3524
Phone
(603) 668-6434
NPI assigned
Jun 16, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 30, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 02-0342066 NH Primary

Addresses

Primary practice location

30 Canton St
Ste 12
Manchester, NH 03103-3524

Mailing address

17 River Front Dr
Unit 9
Manchester, NH 03102-3264
Phone (603) 668-6356

Other identifiers 1

IdentifierTypeStateIssuer
1588669477MedicaidNH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Apr 8, 2013 through Apr 8, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Elliot Hospital of the City of Manchester PastSince Jan 1, 2023 Accepting new patients
Robert a Fremeau DMD Periodontics PastSince Nov 18, 2010 Accepting new patients
Manchester Dental Surgery and Implant Center Past Accepting new patients

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283126400000",
    "number": "1588669477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 RIVER FRONT DR",
            "address_2": "UNIT 9",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031023264",
            "telephone_number": "603-668-6356",
            "fax_number": "603-628-1998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 CANTON ST",
            "address_2": "STE 12",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031033524",
            "telephone_number": "603-668-6434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREMEAU",
        "first_name": "ROBERT",
        "middle_name": "A",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-16",
        "last_updated": "2010-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "NH",
            "license": "02-0342066",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1588669477",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, NH

Sources for this page

Verify at the official NPI Registry.