Active NPI
Frideres Dental LLC
Doing business as Sisters Dental
- Dental Clinic/Center
- Sisters, OR
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Clinic/Center
- License
- D10577
- Legal business name
- FRIDERES DENTAL LLC
- Doing business as
- Sisters Dental
- Practice address
- 410 E Cascade Ave
Sisters, OR 97759-1158 - Phone
- (406) 431-5058
- NPI assigned
- Jan 19, 2018
- Last updated
- Jan 19, 2018
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Trevor Mathias Bauer Frideres, DMD
- Title
- Dentist
- Phone
- (406) 431-5058
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Clinic/Center | 261QD0000X | D10577 | OR | Primary |
Addresses
Primary practice location
410 E Cascade Ave
Sisters, OR 97759-1158
Mailing address
60748 River Bend Dr
Bend, OR 97702-7909
Phone (406) 431-5058
Other names 1
- Sisters Dental
National Provider Directory
National Provider Directory- Tax ID family
- Frideres Dental LLC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
Ownership & related parties
Subparts reporting this organization as parent 1
Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- General Practice Dentistry
- Sisters, OR
- NPI 1629401575
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1516320000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1516320000000",
"number": "1689182933",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "60748 RIVER BEND DR",
"city": "BEND",
"state": "OR",
"postal_code": "977027909",
"telephone_number": "406-431-5058"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "410 E CASCADE AVE",
"city": "SISTERS",
"state": "OR",
"postal_code": "977591158",
"telephone_number": "406-431-5058"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FRIDERES DENTAL LLC",
"organizational_subpart": "NO",
"enumeration_date": "2018-01-19",
"last_updated": "2018-01-19",
"status": "A",
"authorized_official_last_name": "FRIDERES",
"authorized_official_first_name": "TREVOR",
"authorized_official_middle_name": "MATHIAS BAUER",
"authorized_official_title_or_position": "DENTIST",
"authorized_official_telephone_number": "406-431-5058",
"authorized_official_credential": "DMD"
},
"taxonomies": [
{
"code": "261QD0000X",
"taxonomy_group": "",
"desc": "Clinic/Center, Dental",
"state": "OR",
"license": "D10577",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Sisters Dental",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Sisters, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.