Active NPI
Conrad Ferdinand Frey III, D.D.S, M.S.
- Prosthodontics
- Lafayette, LA
National Provider Identifier
1962573766
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthodontics
- License
- 4783
- Practice address
- 185 S Beadle Rd
Building 1, Suite C
Lafayette, LA 70508-4287 - Phone
- (337) 354-0004
- Fax
- (337) 354-0005
- NPI assigned
- Nov 13, 2006
- 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 |
|---|---|---|---|---|
| Prosthodontics | 1223P0700X | 4783 | LA | Primary |
Addresses
Primary practice location
185 S Beadle Rd
Building 1, Suite C
Lafayette, LA 70508-4287
Mailing address
185 S Beadle Rd
Building 1, Suite C
Lafayette, LA 70508-4287
Phone (337) 354-0004
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4783 | LA | MD | Prosthodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163376000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1962573766",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "185 S BEADLE RD",
"address_2": "BUILDING 1, SUITE C",
"city": "LAFAYETTE",
"state": "LA",
"postal_code": "705084287",
"telephone_number": "337-354-0004",
"fax_number": "337-354-0005"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "185 S BEADLE RD",
"address_2": "BUILDING 1, SUITE C",
"city": "LAFAYETTE",
"state": "LA",
"postal_code": "705084287",
"telephone_number": "337-354-0004",
"fax_number": "337-354-0005"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FREY",
"first_name": "CONRAD",
"middle_name": "FERDINAND",
"name_prefix": "Dr.",
"name_suffix": "III",
"credential": "D.D.S, M.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0700X",
"taxonomy_group": "",
"desc": "Dentist, Prosthodontics",
"state": "LA",
"license": "4783",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lafayette, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.