Individual provider Active NPI

Fred S Maron

  • General Practice Dentistry
  • Poughkeepsie, NY
National Provider Identifier
1659453595
Registry record updated Oct 22, 2025
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Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
031833 Issued in NY
Practice address
541 Haight Ave
Poughkeepsie, NY 12603-7231
Phone
(845) 454-0380
Fax
(845) 454-2320
NPI assigned
Oct 19, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 22, 2025

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 031833 NY Primary

Addresses

Primary practice location

541 Haight Ave
Poughkeepsie, NY 12603-7231

Mailing address

541 Haight Ave
Poughkeepsie, NY 12603-7231
Phone (845) 454-0380

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20081009000166 NY Practitioner - DentistPractitioner - Oral Surgery 3072681642 Practice locations: Poughkeepsie, NY
O20140121000577 NY DME Supplier - Physician - General Practice 4880822840 Practice locations: Poughkeepsie, NY

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
031833NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761091200000",
    "number": "1659453595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "541 HAIGHT AVE",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126037231",
            "telephone_number": "845-454-0380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "541 HAIGHT AVE",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126037231",
            "telephone_number": "845-454-0380",
            "fax_number": "845-454-2320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARON",
        "first_name": "FRED",
        "middle_name": "S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-19",
        "last_updated": "2025-10-22",
        "certification_date": "2025-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "031833",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poughkeepsie, NY

Sources for this page

Verify at the official NPI Registry.