Individual provider Active NPI

Gordon Abba Freed, D.M.D.

  • General Practice Dentistry
  • Amherst, MA
National Provider Identifier
1720162589
Registry record updated Mar 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
15163 Issued in MA
Practice address
28 University Dr
Amherst, MA 01002-2243
Phone
(413) 549-3608
Fax
(413) 549-5206
NPI assigned
Oct 25, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 15163 MA Primary

Addresses

Primary practice location

28 University Dr
Amherst, MA 01002-2243

Mailing address

28 University Dr
Amherst, MA 01002-2243
Phone (413) 549-3608

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
I20150406000080 MA Order and Referring Only - DentistPractitioner - Dentist 0143548057

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
15163MAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Ayad Ahmed DMD PLLC PastSince Jan 28, 2024 Accepting new patients
Gordon a Freed Barbara W Freed General Practice Past Accepting new patients

Organizations & group practices 2

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": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710201600000",
    "number": "1720162589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 UNIVERSITY DR",
            "city": "AMHERST",
            "state": "MA",
            "postal_code": "010022243",
            "telephone_number": "413-549-3608",
            "fax_number": "413-549-5206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 UNIVERSITY DR",
            "city": "AMHERST",
            "state": "MA",
            "postal_code": "010022243",
            "telephone_number": "413-549-3608",
            "fax_number": "413-549-5206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREED",
        "first_name": "GORDON",
        "middle_name": "ABBA",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-25",
        "last_updated": "2024-03-12",
        "certification_date": "2024-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "15163",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Amherst, MA

Sources for this page

Verify at the official NPI Registry.