Active NPI
Benjamin Fragale, DMD
- Endodontics
- Tallahassee, FL
National Provider Identifier
1932367729
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- DN17661
- Practice address
- 2408 West Plaza Dr Ste a
Tallahassee, FL 32308 - Phone
- (850) 597-9174
- Fax
- (850) 597-9175
- NPI assigned
- May 28, 2008
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endodontics | 1223E0200X | DN17661 | FL | Primary |
Addresses
Primary practice location
2408 West Plaza Dr Ste a
Tallahassee, FL 32308
Mailing address
2408 West Plaza Drive
Tallahassee, FL 32308
Phone (850) 597-9174
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160512001947 | FL | Order and Referring Only - Dentist | 5496044513 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN17661 | FL | MD | Endodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1211932800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1225152000000",
"number": "1932367729",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2408 WEST PLAZA DRIVE",
"city": "TALLAHASSEE",
"state": "FL",
"postal_code": "32308",
"telephone_number": "850-597-9174",
"fax_number": "850-597-9175"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2408 WEST PLAZA DR STE A",
"city": "TALLAHASSEE",
"state": "FL",
"postal_code": "32308",
"telephone_number": "850-597-9174",
"fax_number": "850-597-9175"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FRAGALE",
"first_name": "BENJAMIN",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-05-28",
"last_updated": "2008-10-28",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "FL",
"license": "DN17661",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tallahassee, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2008; 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.