James Terry Frey, DDS – General Practice Dentistry

Key facts

NPI: 1922011337
Entity type: Individual (NPI type 1)
Primary specialty: General Practice Dentistry 1223G0001X
License: 12006939 (IN)
Practice address: 623 N State Street
North Vernon, IN 47265
Phone: (812) 346-6884
Fax: (812) 346-6884
NPI assigned: Aug 15, 2006
Sex: Male
Sole proprietor: No

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 and National Provider Directory roles.

J Terry Frey DDS PC General Practice Dentistry · North Vernon, IN · NPI 1033212071

NPD (past) Authorized official GENERAL PRACTICE
North Vernon Family Dental LLC Dentist · North Vernon, IN · NPI 1669820643

NPD (past) DENTIST

Medicare participation

Medicare fee-for-service enrollment: Enrolled in IN
Eligible to order & refer: Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
I20151009000195	IN	Order and Referring Only - Dentist Practitioner - Dentist	6507174646

National Provider Directory

Medicare enrollment (NPD): Yes

State licenses

License	State	Type	Specialty
12006939	IN	MD	General Practice Dentistry

Practice roles

Organization	Specialty	Status	New patients
North Vernon Family Dental LLC	Dentist	Past	Accepting new patients
J Terry Frey DDS PC	General Practice	Past	Accepting new patients

Interoperability endpoints

Direct secure messaging: james.frey.p1@direct.northshorehealth.nextgenshare.com

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Dentist	122300000X	DB-2025-0516	NM
General Practice Dentistry	1223G0001X	12006939	IN	Yes

Addresses

Primary practice location

623 N State Street
North Vernon, IN 47265

Mailing address

PO Box 1008
North Vernon, IN 47265-5008
Phone (812) 346-6884

Other practice location 1

4120 Barbara Loop SE
Rio Rancho, NM 87124-1000
Phone (505) 498-3235

Other identifiers

Identifier	Type	State	Issuer
200271690A	Medicaid	IN

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jun 25, 2026.

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782345600000",
    "number": "1922011337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1008",
            "city": "NORTH VERNON",
            "state": "IN",
            "postal_code": "472655008",
            "telephone_number": "812-346-6884",
            "fax_number": "812-346-1717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "623 N STATE STREET",
            "city": "NORTH VERNON",
            "state": "IN",
            "postal_code": "47265",
            "telephone_number": "812-346-6884",
            "fax_number": "812-346-6884"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4120 Barbara Loop SE",
            "address_purpose": "LOCATION",
            "city": "Rio Rancho",
            "state": "NM",
            "postal_code": "871241000",
            "country_code": "US",
            "telephone_number": "505-498-3235",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FREY",
        "first_name": "JAMES",
        "middle_name": "TERRY",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-15",
        "last_updated": "2026-06-25",
        "certification_date": "2026-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NM",
            "license": "DB-2025-0516",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12006939",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200271690A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Vernon, IN

All providers in North Vernon, IN · General Practice Dentistry in Indiana

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 25, 2026. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
Order and Referring (CMS).
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.