Individual provider Active NPI

James P. Frett, DDS

  • Dentist
  • Mount Prospect, IL
National Provider Identifier
1912080391
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Practice address
407 W Prospect Ave
Mt Prospect, IL 60056-3059
Phone
(847) 253-8811
Fax
(847) 253-8811
NPI assigned
Oct 23, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X IL Primary

Addresses

Primary practice location

407 W Prospect Ave
Mt Prospect, IL 60056-3059

Mailing address

407 W Prospect Ave
Mt Prospect, IL 60056-3059
Phone (847) 253-8811

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150619000665 IL Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 0547571382

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019-016937ILMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1912080391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 W PROSPECT AVE",
            "city": "MT PROSPECT",
            "state": "IL",
            "postal_code": "600563059",
            "telephone_number": "847-253-8811",
            "fax_number": "847-253-8811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 W PROSPECT AVE",
            "city": "MT PROSPECT",
            "state": "IL",
            "postal_code": "600563059",
            "telephone_number": "847-253-8811",
            "fax_number": "847-253-8811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRETT",
        "first_name": "JAMES",
        "middle_name": "P.",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Prospect, IL

Sources for this page

Verify at the official NPI Registry.