DR. JOSEPH DEREK FRIDGEN (NPI# 1003980194) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1003980194 |
Entity Type | Individual |
Full Name | DR. JOSEPH DEREK FRIDGEN |
Credential | DDS |
Practice Address |
189 N Bascom Ave Ste 200 San Jose CA 95128-1869 |
Practice Telephone | 4082866315 |
Practice Fax Number | 4082866319 |
Mailing Telephone | 4082866315 |
Mailing Fax Number | 4082866319 |
Enumeration Date | 2006-11-20 |
Last Update Date | 2007-07-08 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
50909 | CA | Dental Providers |
Street Address |
189 N BASCOM AVE STE 200 |
City | SAN JOSE |
State | CA |
Zip Code | 95128-1869 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1871667972 | Joseph Webster Rideau | Dentist | 189 N Bascom Ave Ste 200, San Jose, CA 95128-1869 | 2006-11-20 |
1023182144 | Randy Q. Ligh | Dentist | 189 N Bascom Ave Ste 200, San Jose, CA 95128-1869 | 2006-11-20 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1982227138 | Ruth Larsen | Social Worker | 850 S. Bascom Avenue, Suite 280, San Jose, CA 95128 | 2020-05-22 |
1265067185 | Of Two Minds Psychotherapy | Marriage & Family Therapist | 190 S. Bascom Ave, Ste 130, San Jose, CA 95128 | 2020-03-11 |
1982244166 | Cindy Pantoja Escobar | Behavior Technician | 100 O'connor Drive, Suites 21, San Jose, CA 95128 | 2020-01-15 |
1104460591 | Katherine Alexandra Misogas | Pharmacist | 777 Turner Dr # 330, San Jose, CA 95128 | 2019-10-29 |
1942842216 | Jodie Pierce | Marriage & Family Therapist | 871 Enborg Lane, San Jose, CA 95128 | 2019-10-08 |
1003466434 | Dong Mi Cha | Pharmacist | 777 Turner Dr Ste 330, San Jose, CA 95128 | 2019-09-17 |
1114571759 | Sleep Well Acupuncture, Inc | Acupuncturist | 1361 S Winchester Blvd Suite 206, San Jose, CA 95128 | 2019-08-01 |
1083277677 | Wellocity, Inc | Health Educator | 334 Santana Row, 318, San Jose, CA 95128 | 2019-04-18 |
1518428812 | Alexander Diaz | Radiology | 75 South Bascom Ave, San Jose, CA 95128 | 2019-03-28 |
1720542103 | Nanci R Price Inc | Chiropractor | 100 O'connor Dr., Ste 27, San Jose, CA 95128 | 2019-01-30 |
Find all providers in zip 95128 |
Taxonomy Code | 1223P0221X |
Grouping | Dental Providers |
Classification | Dentist |
Specialization | Pediatric Dentistry |
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
Notes: Source: Council on Dental Education and Licensure, American Dental Association |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1932512647 | Agelina Paek | Dentist | 6942 Almaden Expy, San Jose, CA 95120-3201 | 2014-06-10 |
1053748608 | Vincent D Van | Dentist | 1771 Trudean Way, San Jose, CA 95132-1540 | 2013-09-27 |
1013265602 | Nguyen and Tran Dental Corporation | Dentist | 2680 S White Rd Ste 255, San Jose, CA 95148-2080 | 2012-08-29 |
1891063574 | Elizabeth Duell | Dentist | 4635 Piper Drive, San Jose, CA 95129 | 2011-12-08 |
1962792887 | My Phuong Pham | Dentist | 2810 Deerwood Dr, San Jose, CA 95148-2625 | 2011-04-12 |
1124272919 | Suzanne Nguyen | Dentist | 1569 Lexann Ave Ste 222, San Jose, CA 95121-1795 | 2008-11-06 |
1609041482 | Scott Jacks, Dds, Inc | Dentist | 1153 S King Rd, San Jose, CA 95122-2144 | 2008-04-23 |
1891847596 | Cyrus M Akhbari I | Dentist | 1201 Park Ave, Suite#2, San Jose, CA 95126-2919 | 2007-01-16 |
1700957297 | Marilou D Navarro | Dentist | 750 N Capitol Ave Ste C2, San Jose, CA 95133-1942 | 2006-11-13 |
1154334530 | Philip Wolkstein | Dentist | 841 Blossom Hill Rd Ste 210, San Jose, San Jose, CA 95123-2704 | 2006-08-15 |
Find all providers in SAN JOSE |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.