Active NPI
Matthew Darrell Frey, DMD
- Dentist
- Wyndmoor, PA
National Provider Identifier
1598947293
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DS035523
- Practice address
- 504 Spring LN
Wyndmoor, PA 19038-8413 - Phone
- (267) 682-0989
- NPI assigned
- Dec 4, 2007
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | DS035523 | PA | Primary |
Addresses
Primary practice location
504 Spring LN
Wyndmoor, PA 19038-8413
Mailing address
6404 Roosevelt Blvd
Philadelphia, PA 19149-2943
Phone (215) 743-3700
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DS035523 | PA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1196726400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1196726400000",
"number": "1598947293",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6404 ROOSEVELT BLVD",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191492943",
"telephone_number": "215-743-3700",
"fax_number": "215-743-3715"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "504 SPRING LN",
"city": "WYNDMOOR",
"state": "PA",
"postal_code": "190388413",
"telephone_number": "267-682-0989"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FREY",
"first_name": "MATTHEW",
"middle_name": "DARRELL",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-12-04",
"last_updated": "2007-12-04",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "PA",
"license": "DS035523",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wyndmoor, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 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.