Ivan L Freeman, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D6833 Issued in OR

Practice address

1201 NE 7TH St
Suite a
Grants Pass, OR 97526-1451

Phone

(541) 474-4360

Fax

(541) 474-0685

NPI assigned

Mar 9, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1141862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188950400000",
    "number": "1922076652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1418 NW HAWTHORNE AVE",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975261214",
            "telephone_number": "541-474-9381",
            "fax_number": "541-474-0685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 NE 7TH ST",
            "address_2": "SUITE A",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975261451",
            "telephone_number": "541-474-4360",
            "fax_number": "541-474-0685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREEMAN",
        "first_name": "IVAN",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-09",
        "last_updated": "2007-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D6833",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angela Cathleen Franklin, QMHA
• Michael Raymond Franklin
• Charlane A Frazier, WHCNP
• Lawrence Frazier
• Fred Meyer Stores Inc
• Tahnee Rae Freitas, L.M.T
• Tawnya Freudenthaler
• Timothy Kyle Friend
• Monika Froehlich, D.P.M.
• Megan M Frost, MD

• General Practice Dentistry in Grants Pass, OR
• Providers in Grants Pass, OR by specialty
• General Practice Dentistry in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.