NPIMap

Organization Active NPI

Fredrick Dental, PA

Doing business as Jupiter Farms Dental

  • General Practice Dentistry
  • Jupiter, FL
National Provider Identifier
1801014410
Registry record updated Feb 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN14300 Issued in FL
Legal business name
FREDRICK DENTAL, PA
Doing business as
Jupiter Farms Dental
Practice address
10156 W Indiantown Rd
Jupiter, FL 33478-4707
Phone
(561) 743-6700
Fax
(561) 743-9314
NPI assigned
Apr 22, 2007
Last updated
Feb 20, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2008

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

Authorized official

Name
Dr. Jason Wayne Fredrick, D.D.S.
Title
President
Phone
(561) 743-6700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN14300 FL Primary

Addresses

Primary practice location

10156 W Indiantown Rd
Jupiter, FL 33478-4707

Mailing address

10156 W Indiantown Rd
Jupiter, FL 33478-4707
Phone (561) 743-6700

Other names 1

  • Jupiter Farms Dental Doing business as

National Provider Directory

National Provider Directory

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1177200000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203465600000",
    "number": "1801014410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10156 W INDIANTOWN RD",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334784707",
            "telephone_number": "561-743-6700",
            "fax_number": "561-743-9314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10156 W INDIANTOWN RD",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334784707",
            "telephone_number": "561-743-6700",
            "fax_number": "561-743-9314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREDRICK DENTAL, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-22",
        "last_updated": "2008-02-20",
        "status": "A",
        "authorized_official_last_name": "FREDRICK",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "561-743-6700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN14300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jupiter Farms Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jupiter, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2008; 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.