Individual provider Active NPI

Edward Francis Frederick Jr., DMD

  • Dentist
  • Duxbury, MA
National Provider Identifier
1710937503
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
14316 Issued in MA
Practice address
20 Tremont St
Suite 34
Duxbury, MA 02332-5310
Phone
(781) 934-0022
Fax
(781) 934-0080
NPI assigned
May 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 14316 MA Primary

Addresses

Primary practice location

20 Tremont St
Suite 34
Duxbury, MA 02332-5310

Mailing address

20 Tremont St
Suite 34
Duxbury, MA 02332-5310
Phone (781) 934-0022

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20140626000866 TX Practitioner - DentistPractitioner - Oral Surgery 1456576925 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14316MAMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
DHHS IHS Phoenix Area Current Accepting new patients

Locations

515 Shoshone Cir
Elko, NV 89801
Phone (775) 738-2252

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1710937503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 TREMONT ST",
            "address_2": "SUITE 34",
            "city": "DUXBURY",
            "state": "MA",
            "postal_code": "023325310",
            "telephone_number": "781-934-0022",
            "fax_number": "781-934-0080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 TREMONT ST",
            "address_2": "SUITE 34",
            "city": "DUXBURY",
            "state": "MA",
            "postal_code": "023325310",
            "telephone_number": "781-934-0022",
            "fax_number": "781-934-0080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDERICK",
        "first_name": "EDWARD",
        "middle_name": "FRANCIS",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-11",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "14316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duxbury, MA

Sources for this page

Verify at the official NPI Registry.