Frederick Dental Group

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

19534-L Issued in PA

Legal business name

FREDERICK DENTAL GROUP

Practice address

44 S Main St
Wilkes Barre, PA 18701-1705

Phone

(570) 829-2691

NPI assigned

Feb 23, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Donald Frederick IIINPI 1558496026

Title

Sole Proprietor

Phone

(570) 829-2691

Specialties & licenses 1

Addresses

Locations

Practitioners 3

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.

• Donald A Frederick III, D.D.S.

  • General Practice Dentistry
  • Wilkes Barre, PA
  • NPI 1558496026
  NPD (past) Authorized official
• D. Alexander Frederick IV, D.M.D.

  • General Practice Dentistry
  • Wilkes Barre, PA
  • NPI 1548395023
  NPD (past)
• Todd Paczewski, D.M.D.

  • General Practice Dentistry
  • Wilkes Barre, PA
  • NPI 1447386545
  NPD (past)

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

{
    "created_epoch": "1172188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1871628370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "RR 3 BOX 155",
            "city": "HARVEYS LAKE",
            "state": "PA",
            "postal_code": "186189403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44 S MAIN ST",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187011705",
            "telephone_number": "570-829-2691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREDERICK DENTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FREDERICK",
        "authorized_official_first_name": "DONALD",
        "authorized_official_title_or_position": "SOLE PROPRIETOR",
        "authorized_official_telephone_number": "570-829-2691",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "19534-L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas Stephen Franko II, PHARMD
• Regina M Frantz, PHARM D, RPH
• Richard Lewis Frantz, PHARM D
• Kyle Bryan Frazier, DDS
• Monique Yvette Frazier
• D. Alexander Frederick IV, D.M.D.
• Donald A Frederick III, D.D.S.
• Marlaina Frederick, PT
• Louis Jay Freedman, M.D.
• Amy Lynn Freeman, LCSW

• General Practice Dentistry in Wilkes Barre, PA
• Providers in Wilkes Barre, PA by specialty
• General Practice Dentistry in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.