Individual provider Active NPI

Frank Breitfeller, D.D.S.

  • General Practice Dentistry
  • Cumberland, MD
National Provider Identifier
1730177890
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
11555 Issued in MD
Practice address
815 Frederick St
Cumberland, MD 21502-1233
Phone
(301) 722-4277
Fax
(301) 722-4280
NPI assigned
Oct 12, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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 11555 MD Primary

Addresses

Primary practice location

815 Frederick St
Cumberland, MD 21502-1233

Mailing address

14010 Pleasant Valley Rd NE
Flintstone, MD 21530-1040
Phone (301) 777-1863

Other identifiers 1

IdentifierTypeStateIssuer
148224600MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150127001470 MD Order and Referring Only - General PracticePractitioner - General Practice 7618291493

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11555MDMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1129075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1730177890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14010 PLEASANT VALLEY RD NE",
            "city": "FLINTSTONE",
            "state": "MD",
            "postal_code": "215301040",
            "telephone_number": "301-777-1863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 FREDERICK ST",
            "city": "CUMBERLAND",
            "state": "MD",
            "postal_code": "215021233",
            "telephone_number": "301-722-4277",
            "fax_number": "301-722-4280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREITFELLER",
        "first_name": "FRANK",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-12",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "11555",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "148224600",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cumberland, MD

Sources for this page

Verify at the official NPI Registry.