Active NPI
Greg W Frodel, DDS
- General Practice Dentistry
- Pasco, WA
National Provider Identifier
1972633899
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 5567
- Practice address
- 5204 N Road 68
Suite B
Pasco, WA 99301-9275 - Phone
- (509) 547-9955
- Fax
- (509) 544-2827
- NPI assigned
- Mar 7, 2007
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 5567 | WA | Primary |
Addresses
Primary practice location
5204 N Road 68
Suite B
Pasco, WA 99301-9275
Mailing address
5204 N Road 68
Suite B
Pasco, WA 99301-9275
Phone (509) 547-9955
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5567 | Other | WA | STATE LICENSE NUMBER |
| 5778 | Other | WA | DELTA DENTAL INSURANCE |
| 5051891 | Medicaid | WA |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5567 | WA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| West Pasco Family Dental LLC | General Practice | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- General Practice Dentistry
- Pasco, WA
- NPI 1447380233
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173225600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1972633899",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5204 N ROAD 68",
"address_2": "SUITE B",
"city": "PASCO",
"state": "WA",
"postal_code": "993019275",
"telephone_number": "509-547-9955",
"fax_number": "509-544-2827"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5204 N ROAD 68",
"address_2": "SUITE B",
"city": "PASCO",
"state": "WA",
"postal_code": "993019275",
"telephone_number": "509-547-9955",
"fax_number": "509-544-2827"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FRODEL",
"first_name": "GREG",
"middle_name": "W",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-07",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "WA",
"license": "5567",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE NUMBER",
"identifier": "5567",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DELTA DENTAL INSURANCE",
"identifier": "5778",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5051891",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pasco, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.