NPIMap

Organization Active NPI

Scott J Fridrich DDS PC

  • Dentist
  • Boulder, CO
National Provider Identifier
1972840460
Registry record updated Jan 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
104873 Issued in CO
Legal business name
SCOTT J FRIDRICH DDS PC
Practice address
1120 Alpine Ave Ste C
Boulder, CO 80304-3414
Phone
(303) 443-4416
NPI assigned
Jan 3, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2013

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

Authorized official

Name
Dr. Scott Joseph Fridrich, DDS
Title
Doctor of Dental Surgery
Phone
(303) 443-4416

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 104873 CO Primary

Addresses

Primary practice location

1120 Alpine Ave Ste C
Boulder, CO 80304-3414

Mailing address

1120 Alpine Ave Ste C
Boulder, CO 80304-3414
Phone (303) 443-4416

National Provider Directory

National Provider Directory

Locations

1120 Alpine Ave
Ste C
Boulder, CO 80304
Phone (303) 443-4416

NPI Registry JSON

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

{
    "created_epoch": "1357171200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1357171200000",
    "number": "1972840460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 ALPINE AVE STE C",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803043414",
            "telephone_number": "303-443-4416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 ALPINE AVE STE C",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803043414",
            "telephone_number": "303-443-4416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCOTT J FRIDRICH DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-03",
        "last_updated": "2013-01-03",
        "status": "A",
        "authorized_official_last_name": "FRIDRICH",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "DOCTOR OF DENTAL SURGERY",
        "authorized_official_telephone_number": "303-443-4416",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CO",
            "license": "104873",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.