Christy L Frady, D.M.D.

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

6219-15 Issued in WI

Practice address

5810 S 108TH St
Hales Corners, WI 53130-1912

Phone

(414) 350-0945

NPI assigned

Aug 29, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Waterford Childrens Dentistry SC

  • Pediatric Dentistry
  • Waterford, WI
  • NPI 1982385944
  NPD Authorized official

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

{
    "created_epoch": "1188345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553472000000",
    "number": "1801080106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5810 S 108TH ST",
            "city": "HALES CORNERS",
            "state": "WI",
            "postal_code": "531301912",
            "telephone_number": "414-350-0945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5810 S 108TH ST",
            "city": "HALES CORNERS",
            "state": "WI",
            "postal_code": "531301912",
            "telephone_number": "414-350-0945"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2603 W Rawson Ave",
            "address_purpose": "LOCATION",
            "city": "Oak Creek",
            "state": "WI",
            "postal_code": "531548422",
            "country_code": "US",
            "telephone_number": "414-775-7001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FRADY",
        "first_name": "CHRISTY",
        "middle_name": "L",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-29",
        "last_updated": "2019-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "WI",
            "license": "6219-15",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Hoover Eiche, D.D.S.
• Dana Elchami, DDS
• Judith Lynn Fecteau, OT
• Forest View Health Center, L.L.C.
• Forest View Health Center, LLC
• Riley Fuerstenau, MS, LPC-IT
• Lauren Gahan
• Rebecca Mae Ganshert, OT
• Lynette Anne Gerke, PT
• Boris Gigov, PT, DPT

• Pediatric Dentistry in Hales Corners, WI
• Providers in Hales Corners, WI by specialty
• Pediatric Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2019; 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.