Active NPI
Douglas Sterling Fry Sr., DDS
- Pediatric Dentistry
- Wilmington, NC
National Provider Identifier
1811992027
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 3674
- 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, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 92924 | Other | NC | BCBS |
| 8992924 | Medicaid | NC |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 5384 | NE | MD | Mental Health Counselor |
| 2267 | TN | MD | Pediatric Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dr. Douglas S. Fry DDS PLLC | Current | Accepting new patients | |
| Dr.Robert S. Point DDS PLLC | Pediatric Dentistry | Past | 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.
-
- Dentist
- Wilmington, NC
- NPI 1083136568
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.