Individual provider Active NPI

Michael Craig Friedman, DDS

  • Dentist
  • Atlanta, GA
National Provider Identifier
1710153200
Registry record updated May 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN013600 Issued in GA
Practice address
1175 Peachtree St NE
100 Colony Square Suite 1210
Atlanta, GA 30361-6202
Phone
(404) 874-6464
Fax
(404) 874-1831
NPI assigned
May 5, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN013600 GA Primary

Addresses

Primary practice location

1175 Peachtree St NE
100 Colony Square Suite 1210
Atlanta, GA 30361-6202

Mailing address

1175 Peachtree St NE
100 Colony Square Suite 1210
Atlanta, GA 30361-6202
Phone (404) 874-6464

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20150713000993 GA Order and Referring Only - DentistPractitioner - Dentist 1557673035

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN013600GAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1209945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209945600000",
    "number": "1710153200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1175 PEACHTREE ST NE",
            "address_2": "100 COLONY SQUARE SUITE 1210",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303616202",
            "telephone_number": "404-874-6464",
            "fax_number": "404-874-1831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1175 PEACHTREE ST NE",
            "address_2": "100 COLONY SQUARE SUITE 1210",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303616202",
            "telephone_number": "404-874-6464",
            "fax_number": "404-874-1831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIEDMAN",
        "first_name": "MICHAEL",
        "middle_name": "CRAIG",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-05",
        "last_updated": "2008-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GA",
            "license": "DN013600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.