Active NPI
Jennifer Tracy Becker, DDS
- Dentist
- Fremont, OH
National Provider Identifier
1730188400
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 30020483
- Practice address
- 410 Birchard Ave
Fremont, OH 43420-2967 - Phone
- (419) 334-8855
- Fax
- (419) 334-8619
- NPI assigned
- Jul 15, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 30020483 | OH | Primary |
Addresses
Primary practice location
410 Birchard Ave
Fremont, OH 43420-2967
Mailing address
410 Birchard Ave
Fremont, OH 43420-2967
Phone (419) 334-8855
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30020483 | OH | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community and Rural Health Services | Past | Accepting new patients | |
| Community and Rural Health Services | 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.
-
- Rural Health Clinic/Center
- Fremont, OH
- NPI 1437321239
-
- Rural Health Clinic/Center
- Fremont, OH
- NPI 1780683573
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121385600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1345161600000",
"number": "1730188400",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "410 BIRCHARD AVE",
"city": "FREMONT",
"state": "OH",
"postal_code": "434202967",
"telephone_number": "419-334-8855",
"fax_number": "419-334-8619"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "410 BIRCHARD AVE",
"city": "FREMONT",
"state": "OH",
"postal_code": "434202967",
"telephone_number": "419-334-8855",
"fax_number": "419-334-8619"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BECKER",
"first_name": "JENNIFER",
"middle_name": "TRACY",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-07-15",
"last_updated": "2012-08-17",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "OH",
"license": "30020483",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fremont, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.