Individual provider Active NPI

Brent Jordan Frey, DDS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Hyattsville, MD
National Provider Identifier
1780988576
Registry record updated Jan 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
14696 Issued in MD
Practice address
6525 Belcrest Rd Ste 290
Hyattsville, MD 20782-2062
Phone
(301) 249-4123
NPI assigned
Jan 7, 2011
Last updated
Jan 22, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 22, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 0401412360 VA
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X DEN1000872 DC
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223X0400X 14696 MD Primary

Addresses

Primary practice location

6525 Belcrest Rd Ste 290
Hyattsville, MD 20782-2062

Mailing address

6525 Belcrest Rd Ste 290
Hyattsville, MD 20782-2062
Phone (248) 376-1059

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
0401412360VAMDDentist
DEN1000872DCMDOrthodontics and Dentofacial Orthopedic Dentist
14696MDMDOrthodontics and Dentofacial Orthopedic Dentist

NPI Registry JSON

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

{
    "created_epoch": "1294358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705881600000",
    "number": "1780988576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6525 BELCREST RD STE 290",
            "city": "HYATTSVILLE",
            "state": "MD",
            "postal_code": "207822062",
            "telephone_number": "248-376-1059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6525 BELCREST RD STE 290",
            "city": "HYATTSVILLE",
            "state": "MD",
            "postal_code": "207822062",
            "telephone_number": "301-249-4123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREY",
        "first_name": "BRENT",
        "middle_name": "JORDAN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-01-07",
        "last_updated": "2024-01-22",
        "certification_date": "2024-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401412360",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "DC",
            "license": "DEN1000872",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "MD",
            "license": "14696",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hyattsville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2024; 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.