Peter Shigeki Frandsen, DDS
Individual provider Active NPI Pediatric Dentistry · Hill Afb, UT
NPI 1982910907 · NPPES record last updated Aug 4, 2020
Key facts
- NPI
- 1982910907
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatric Dentistry 1223P0221X
- License
- 102214 (WI)
- Practice address
- 7321 Balmer Street BLDG #570
Hill Afb, 75TH MDG/SGD
Hill Afb, UT 84056 - Phone
- (801) 777-7011
- Fax
- (801) 777-0590
- NPI assigned
- Aug 27, 2010
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Interoperability endpoints
- pfrandsen516612@direct.emplifyhealth.org
- pfrandsen516612@direct.gundersenhealth.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Pediatric Dentistry | 1223P0221X | 102214 | WI | Yes |
Addresses
Primary practice location
7321 Balmer Street BLDG #570
Hill Afb, 75TH MDG/SGD
Hill Afb, UT 84056
Mailing address
7321 Balmer Street BLDG #570
Hill Afb, 75TH MDG/SGD
Hill Afb, UT 84056
Phone (801) 777-7011
Other providers in Hill Afb, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 4, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.