Kiana Fredette
Individual provider Active NPI Dentist · Lakeville, MA
NPI 1992496467 · NPPES record last updated Jun 13, 2023
Key facts
- NPI
- 1992496467
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- DN1859790 (MA)
- Practice address
- 336 Bedford St
Lakeville, MA 02347-2136 - Phone
- (508) 802-5173
- NPI assigned
- May 16, 2023
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN1859790 | MA | MD | Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DN1859790 | MA | Yes |
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
Other providers in Lakeville, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 13, 2023. 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.