Courtney Lynn Fridella, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

25987 Issued in FL

Practice address

22 Adalia Ave
Tampa, FL 33606-3302

Phone

(727) 409-1339

NPI assigned

Jun 15, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Networks

• Freedom Health HMO Network

Interoperability endpoints

• Direct secure messaging: courtneyfridella28@mydentalmail.com

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

{
    "created_epoch": "1623715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623715200000",
    "number": "1609444629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 ADALIA AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336063302",
            "telephone_number": "727-409-1339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 ADALIA AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336063302",
            "telephone_number": "727-409-1339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIDELLA",
        "first_name": "COURTNEY",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-15",
        "last_updated": "2021-06-15",
        "certification_date": "2021-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "25987",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "FL",
            "license": "25987",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Courtneyfridella28@mydentalmail.com",
            "affiliation": "N",
            "address_1": "22 Adalia Ave",
            "city": "Tampa",
            "state": "FL",
            "country_code": "US",
            "postal_code": "336063302",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Rafael A Frias
• Samantha C Fricano, BCBA
• Melissa Frick
• Lia Marie Fricke, MS RD LDN
• Cathy Friday, LMT
• Tammy Fried, LCSW
• Andrew Friedl
• Friedman & Rodriguez Psychology Associates PA
• Amy Lynn Friedman, LCSW
• Andrea Lynn Friedman, PH.D.

• Dentist in Tampa, FL
• Providers in Tampa, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2021; 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.