Active NPI
Kiana Fredette
- Dentist
- Lakeville, MA
National Provider Identifier
1992496467
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DN1859790
- Practice address
- 336 Bedford St
Lakeville, MA 02347-2136 - Phone
- (508) 802-5173
- NPI assigned
- May 16, 2023
- Last updated
- Jun 13, 2023
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | DN1859790 | MA | Primary |
Addresses
Primary practice location
336 Bedford St
Lakeville, MA 02347-2136
Mailing address
48 N Precinct St
East Taunton, MA 02718-1516
Phone (774) 218-1171
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 |
|---|---|---|---|
| DN1859790 | MA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1684195200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1686614400000",
"number": "1992496467",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "48 N PRECINCT ST",
"city": "EAST TAUNTON",
"state": "MA",
"postal_code": "027181516",
"telephone_number": "774-218-1171"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "336 BEDFORD ST",
"city": "LAKEVILLE",
"state": "MA",
"postal_code": "023472136",
"telephone_number": "508-802-5173"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FREDETTE",
"first_name": "KIANA",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-05-16",
"last_updated": "2023-06-13",
"certification_date": "2023-06-13",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MA",
"license": "DN1859790",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lakeville, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.