Marc D Friduss, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

LNO 5731 Issued in AL

Practice address

4547 Saint Stephens Rd
Eight Mile, AL 36613-3563

Phone

(251) 456-1399

Fax

(251) 456-0079

NPI assigned

Jun 28, 2006

Last updated

May 15, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AL

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Health Services Inc

  dba Hayneville Family Health Center

  • Federally Qualified Health Center (FQHC)
  • Hayneville, AL
  • NPI 1598788218
  NPD
• Health Services, Inc

  dba Montgomery Primary Care

  • Federally Qualified Health Center (FQHC)
  • Montgomery, AL
  • NPI 1528082336
  NPD
• Health Services, Inc.

  dba Living Well Specialty Clinic

  • Federally Qualified Health Center (FQHC)
  • Montgomery, AL
  • NPI 1184284986
  NPD
• Mobile County Board of Health

  dba Mobile Medical Van

  • Federally Qualified Health Center (FQHC)
  • Mobile, AL
  • NPI 1659584555
  NPD (past)

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368576000000",
    "number": "1699702159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1725 E SHERMAN BLVD",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494441862",
            "telephone_number": "231-737-0037",
            "fax_number": "231-760-5497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4547 SAINT STEPHENS RD",
            "city": "EIGHT MILE",
            "state": "AL",
            "postal_code": "366133563",
            "telephone_number": "251-456-1399",
            "fax_number": "251-456-0079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIDUSS",
        "first_name": "MARC",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-28",
        "last_updated": "2013-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019018828",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AL",
            "license": "LNO 5731",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Indya Niccole Drinkard, LCSW
• Eight Mile Nursing and Rehabilitation Center, LLC (North Mobile Nursing and Rehabilitation Center)
• Mari Scott Emanuel
• Ashley Estrada
• Eternal Light Care Services LLC
• Allison Renee Gaillard
• Latasha Denise Harrison
• Cheryl Voncille Harvey, CRNP
• Healing Hands Medical Equipment & Suppliers LLC
• Hill's Group Home Inc.

• Dentist in Eight Mile, AL
• Providers in Eight Mile, AL by specialty
• Dentist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.