Individual provider Active NPI

Maria Paula Fedler, D.D.S

  • General Practice Dentistry
  • Hermitage, TN
National Provider Identifier
1780910067
Registry record updated Oct 21, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
9073 Issued in TN
Practice address
5045 Old Hickory Blvd Ste 102
Hermitage, TN 37076-2581
Phone
(615) 872-9269
Fax
(615) 872-9362
NPI assigned
Oct 21, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2009

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 9073 TN Primary

Addresses

Primary practice location

5045 Old Hickory Blvd Ste 102
Hermitage, TN 37076-2581

Mailing address

5045 Old Hickory Blvd Ste 102
Hermitage, TN 37076-2581
Phone (615) 872-9269

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

LicenseStateTypeSpecialty
9073TNMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1256083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1256083200000",
    "number": "1780910067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5045 OLD HICKORY BLVD STE 102",
            "city": "HERMITAGE",
            "state": "TN",
            "postal_code": "370762581",
            "telephone_number": "615-872-9269",
            "fax_number": "615-872-9362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5045 OLD HICKORY BLVD STE 102",
            "city": "HERMITAGE",
            "state": "TN",
            "postal_code": "370762581",
            "telephone_number": "615-872-9269",
            "fax_number": "615-872-9362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEDLER",
        "first_name": "MARIA",
        "middle_name": "PAULA",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-21",
        "last_updated": "2009-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "9073",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hermitage, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.