Individual provider Active NPI

Edward Neil Friedman, DDS

  • Dentist
  • Brookline, MA
National Provider Identifier
1689685836
Registry record updated Jan 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
12396 Issued in MA
Practice address
50 Longwood Ave
Apt 1014
Brookline, MA 02446
Phone
(617) 738-9293
NPI assigned
Aug 11, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 15, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 12396 MA Primary
General Practice Dentistry 1223G0001X 61182 CA

Addresses

Primary practice location

50 Longwood Ave
Apt 1014
Brookline, MA 02446

Mailing address

50 Longwood Ave
#1014
Brookline, MA 02446
Phone (617) 738-9293

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20150718000012 MA Order and Referring Only - DentistPractitioner - Dentist 7012220114

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12396MAMDDentist
61182CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358208000000",
    "number": "1689685836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 LONGWOOD AVE",
            "address_2": "#1014",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "02446",
            "telephone_number": "617-738-9293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 LONGWOOD AVE",
            "address_2": "APT 1014",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "02446",
            "telephone_number": "617-738-9293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIEDMAN",
        "first_name": "EDWARD",
        "middle_name": "NEIL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-11",
        "last_updated": "2013-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "12396",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "61182",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookline, MA

Sources for this page

Verify at the official NPI Registry.