Active NPI
Susan Fredericks, D.D.S
- General Practice Dentistry
- Woodland Hills, CA
National Provider Identifier
1679805782
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 29885
- Practice address
- 6325 Topanga Canyon Blvd Ste 402
Woodland Hills, CA 91367-2036 - Phone
- (818) 346-3337
- NPI assigned
- Feb 1, 2010
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 29885 | CA | Primary |
Addresses
Primary practice location
6325 Topanga Canyon Blvd Ste 402
Woodland Hills, CA 91367-2036
Mailing address
6325 Topanga Canyon Blvd Ste 402
Woodland Hills, CA 91367-2036
Phone (818) 346-3337
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 |
|---|---|---|---|
| 29885 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1264982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1264982400000",
"number": "1679805782",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6325 TOPANGA CANYON BLVD STE 402",
"city": "WOODLAND HILLS",
"state": "CA",
"postal_code": "913672036",
"telephone_number": "818-346-3337"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6325 TOPANGA CANYON BLVD STE 402",
"city": "WOODLAND HILLS",
"state": "CA",
"postal_code": "913672036",
"telephone_number": "818-346-3337"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FREDERICKS",
"first_name": "SUSAN",
"name_prefix": "Dr.",
"credential": "D.D.S",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-02-01",
"last_updated": "2010-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "29885",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Woodland Hills, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.