Individual provider Active NPI

Douglas Sterling Fry Sr., DDS

  • Pediatric Dentistry
  • Wilmington, NC
National Provider Identifier
1811992027
Registry record updated Oct 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
3674 Issued in NC
Practice address
1911 S 17TH St
Ste 140
Wilmington, NC 28401-6662
Phone
(910) 762-7736
Fax
(910) 251-8845
NPI assigned
Jun 15, 2005
Last updated
Oct 3, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 3, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 3674 NC Primary
Pediatric Dentistry 1223P0221X 2267 TN
Pediatric Dentistry 1223P0221X 5384 NE

Addresses

Primary practice location

1911 S 17TH St
Ste 140
Wilmington, NC 28401-6662

Mailing address

1911 S 17TH St
Ste 140
Wilmington, NC 28401-6662
Phone (910) 762-7736

Other identifiers 2

IdentifierTypeStateIssuer
92924OtherNCBCBS
8992924MedicaidNC

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
5384NEMDMental Health Counselor
2267TNMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Douglas S. Fry DDS PLLC CurrentSince Jul 24, 2022 Accepting new patients
Dr.Robert S. Point DDS PLLC Pediatric Dentistry PastSince Jan 21, 2022 Accepting new patients

Locations

1911 S 17th St
Ste 140
Wilmington, NC 28401
Phone (910) 762-7736

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1118793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475452800000",
    "number": "1811992027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1911 S 17TH ST",
            "address_2": "STE 140",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284016662",
            "telephone_number": "910-762-7736",
            "fax_number": "910-251-8845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1911 S 17TH ST",
            "address_2": "STE 140",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284016662",
            "telephone_number": "910-762-7736",
            "fax_number": "910-251-8845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRY",
        "first_name": "DOUGLAS",
        "middle_name": "STERLING",
        "name_prefix": "Dr.",
        "name_suffix": "Sr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-15",
        "last_updated": "2016-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NC",
            "license": "3674",
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "TN",
            "license": "2267",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NE",
            "license": "5384",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "92924",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8992924",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2016; 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.