Individual provider Active NPI

Nathaniel David Frye, DDS, MS

  • Dentist
  • Fairlawn, OH
National Provider Identifier
1720578669
Registry record updated Sep 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
30.025378 Issued in OH
Practice address
3075 Smith Rd Ste 201
Fairlawn, OH 44333-4454
Phone
(330) 666-0400
Fax
(330) 666-0130
NPI assigned
May 16, 2018
Last updated
Sep 12, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 30.025378 OH Primary
Endodontics 1223E0200X 30.025378 OH

Addresses

Primary practice location

3075 Smith Rd Ste 201
Fairlawn, OH 44333-4454

Mailing address

4316 Chestnut Rd
Independence, OH 44131-3760
Phone (814) 758-0476

Other identifiers 2

IdentifierTypeStateIssuer
0286281MedicaidOH
30.025378OtherOHOHIO STATE DENTAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20200708003239 OH Order and Referring Only - DentistPractitioner - Dentist 8628491768

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
DRS.J. Kotapish & C. Kayafas, Inc. Endodontics PastSince Sep 20, 2022 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1526428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662940800000",
    "number": "1720578669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4316 CHESTNUT RD",
            "city": "INDEPENDENCE",
            "state": "OH",
            "postal_code": "441313760",
            "telephone_number": "814-758-0476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3075 SMITH RD STE 201",
            "city": "FAIRLAWN",
            "state": "OH",
            "postal_code": "443334454",
            "telephone_number": "330-666-0400",
            "fax_number": "330-666-0130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRYE",
        "first_name": "NATHANIEL",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "DDS, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-16",
        "last_updated": "2022-09-12",
        "certification_date": "2022-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30.025378",
            "primary": true
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "OH",
            "license": "30.025378",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0286281",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OHIO STATE DENTAL LICENSE",
            "identifier": "30.025378",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairlawn, OH

Sources for this page

Verify at the official NPI Registry.