Individual provider Active NPI

Margaux Fraundorfer, DDS

  • General Practice Dentistry
  • Anderson, IN
National Provider Identifier
1619991247
Registry record updated Apr 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
10703 Issued in IN
Practice address
2126 E 5TH St
Anderson, IN 46012-3529
Phone
(765) 644-8828
Fax
(765) 642-8886
NPI assigned
Jul 27, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 25, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 10703 IN Primary

Addresses

Primary practice location

2126 E 5TH St
Anderson, IN 46012-3529

Mailing address

2126 E 5TH St
Anderson, IN 46012-3529
Phone (765) 644-8828

Other identifiers 1

IdentifierTypeStateIssuer
200510060MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150611001268 IN Order and Referring Only - DentistPractitioner - Dentist 9436470762

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10703INMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Margaux M. Fraundorfer, DDS CurrentSince Apr 30, 2023 Accepting new patients
Ladd Dental of Greentown P.C. General Practice Past Accepting new patients

Locations

2126 E 5th St
Anderson, IN 46012
Phone (765) 644-8828

Interoperability endpoints

  • Direct secure messaging: marguax.fraundorfer.p1@direct.meridianhs.nextgenshare.com

Organizations & group practices 2

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": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682380800000",
    "number": "1619991247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2126 E 5TH ST",
            "city": "ANDERSON",
            "state": "IN",
            "postal_code": "460123529",
            "telephone_number": "765-644-8828",
            "fax_number": "765-642-8886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2126 E 5TH ST",
            "city": "ANDERSON",
            "state": "IN",
            "postal_code": "460123529",
            "telephone_number": "765-644-8828",
            "fax_number": "765-642-8886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRAUNDORFER",
        "first_name": "MARGAUX",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-27",
        "last_updated": "2023-04-25",
        "certification_date": "2023-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "10703",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200510060",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anderson, IN

Sources for this page

Verify at the official NPI Registry.