NPIMap

Organization Active NPI

Jay R. Froug, D.M.D., P.a. D/B/a Pinebrook Dental Center

  • General Practice Dentistry
  • Bradenton, FL
National Provider Identifier
1811107485
Registry record updated Jun 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN0010494 Issued in FL
Legal business name
JAY R. FROUG, D.M.D., P.A. D/B/A PINEBROOK DENTAL CENTER
Practice address
4868 Cortez Rd W
Bradenton, FL 34210-2803
Phone
(941) 795-0877
Fax
(941) 795-5316
NPI assigned
May 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2008

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

Authorized official

Name
Dr. Jay Richard Froug, DMDNPI 1639308174
Title
Owner
Phone
(941) 795-0877

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X DN0010494 FL Primary

Addresses

Primary practice location

4868 Cortez Rd W
Bradenton, FL 34210-2803

Mailing address

4868 Cortez Rd W
Bradenton, FL 34210-2803
Phone (941) 795-0877

Other identifiers 4

IdentifierTypeStateIssuer
59129772OtherALBCBS OF AL
67366OtherBCBS
410947OtherPAUNITED CONCORDIA
ZP9540OtherMABCBS OF MA

National Provider Directory

National Provider Directory

Locations

4868 Cortez Rd W
Bradenton, FL 34210
Phone (941) 795-0877

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214352000000",
    "number": "1811107485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4868 CORTEZ RD W",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342102803",
            "telephone_number": "941-795-0877",
            "fax_number": "941-795-5316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4868 CORTEZ RD W",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342102803",
            "telephone_number": "941-795-0877",
            "fax_number": "941-795-5316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAY R. FROUG, D.M.D., P.A. D/B/A PINEBROOK DENTAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-23",
        "last_updated": "2008-06-25",
        "status": "A",
        "authorized_official_last_name": "FROUG",
        "authorized_official_first_name": "JAY",
        "authorized_official_middle_name": "RICHARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "941-795-0877",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN0010494",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF AL",
            "identifier": "59129772",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "67366",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "410947",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MA",
            "identifier": "ZP9540",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

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