DR. TIMOTHY J FREY (NPI# 1558371609) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558371609 |
| Entity Type | Individual |
| Full Name | DR. TIMOTHY J FREY |
| Credential | DDS |
| Practice Address |
4606 D East State Blvd Fort Wayne IN 46815-6963 |
| Practice Telephone | 2604232340 |
| Practice Fax Number | 2604225342 |
| Mailing Telephone | 2604232340 |
| Mailing Fax Number | 2604225342 |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2015-08-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
12009756 | IN | Dental Providers |
| Y | 204E00000X | Oral & Maxillofacial Surgery | 12009756 | IN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 200029030 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770500225 | Timothy Michael Frey | Chiropractor | 390 Independence Drive, Napoleon, OH 43545 | 2006-07-17 |
| 1447298385 | Timothy C. Frey | Family Medicine | 5601 N. Antioch, Creekwood Family Care, Ste. 12, Gladstone, MO 64119 | 2006-06-03 |
| 1053467969 | Timothy Frey | Radiology | 736 Cambridge St, Department of Radiology, Boston, MA 02135-2907 | 2007-01-25 |
| Street Address |
4606 D EAST STATE BLVD |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46815-6963 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487664512 | David G Bojrab | Dentist | 4606 D East State Blvd, Fort Wayne, IN 46815 | 2006-08-09 |
| 1376553412 | John E Buhler Jr | Dentist | 4606 D East State Blvd, Fort Wayne, IN 46815-6963 | 2006-08-09 |
| 1124038260 | Timothy J Shambaugh | Dentist | 4606 D East State Blvd, Fort Wayne, IN 46815-6963 | 2006-08-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306305438 | Sullivan Services, Inc. | In Home Supportive Care | 2789-b Maplecrest Rd, Fort Wayne, IN 46815 | 2019-03-18 |
| 1598250144 | Altermease Gleason | Massage Therapist | 3406 Thames Drive, Fort Wayne, IN 46815 | 2018-06-26 |
| 1881000222 | Denise Sparks | Specialist | 6415 Benham Drive, Fort Wayne, IN 46815 | 2014-07-07 |
| 1962823138 | Chad Distelrath | Physical Therapy Assistant | 1717 Maplecrest Rd, Apt 112, Fort Wayne, IN 46815 | 2013-12-13 |
| 1689943409 | Kendall Joan Labrash | Physical Therapist | 4251 Lahmeyer Rd., Fort Wayne, IN 46815 | 2011-12-22 |
| 1801179718 | Jayson Laube | Pharmacist | 6201 Stellhorn, Fort Wayne, IN 46815 | 2011-09-27 |
| 1720294432 | Muscle Therapy Clinic LLC | Massage Therapist | 6409 Georgetown North Blvd, Fort Wayne, IN 46815 | 2007-05-16 |
| 1427186436 | Legoras Conture Fashions | Prosthetic/Orthotic Supplier | 3316 Inwood Drive, Fort Wayne, IN 46815 | 2007-03-01 |
| 1932252772 | Fort Wayne Smiles PC | Dentist | 2031 Reed Road, Fort Wayne, IN 46815 | 2007-01-18 |
| 1811078538 | Timothy Doody Lynch | Dentist | 4207 Hobson Court, Fort Wayne, IN 46815 | 2006-10-18 |
| Find all providers in zip 46815 | ||||
| Taxonomy Code | 204E00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Oral & Maxillofacial Surgery |
| Oral and maxillofacial surgeons are trained to recognize and treat a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. They are also trained to administer anesthesia, and provide care in an office setting. They are trained to treat problems such as the extraction of wisdom teeth, misaligned jaws, tumors and cysts of the jaw and mouth, and to perform dental implant surgery. |
| Notes: Source: American College of Surgeons, 2013. www.facs.org [7/1/2013: definition added, source added, additional resources added] Additional Resources: American Board of Oral and Maxillofacial Surgery and American Association of Oral and Maxillofacial Surgeons While this is generally considered a specialty of dentistry, physicians can also be board certified as oral and maxillofacial surgeons through the American Board of Oral and Maxillofacial Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831264324 | Oral & Maxillofacial Surgery Associates PC | Oral & Maxillofacial Surgery | 7845 Carnegie Blvd, Fort Wayne, IN 46804 | 2006-11-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295041093 | Central Indiana Oral Surgery and Implantology | Oral & Maxillofacial Surgery | 272 Medical Dr., Carmel, IN 46032 | 2010-08-31 |
| 1386762318 | Bloomington Oral & Maxillofacial Surgery Group | Oral & Maxillofacial Surgery | 637 S Walker Street, Suite 1, Bloomington, IN 47403-2154 | 2007-03-27 |
| 1083757355 | Carrie A. Klene | Oral & Maxillofacial Surgery | 715 W Carmel Dr Ste 102, Carmel, IN 46032-5881 | 2007-02-15 |
| 1689743809 | Rodney P Swantko | Oral & Maxillofacial Surgery | 9250 Columbia Avenue, Suite D 1, Munster, IN 46321 | 2006-11-06 |
| 1114007838 | Micheal J Deady Dds Inc | Oral & Maxillofacial Surgery | 1630 Poplar St, Terre Haute, IN 47807 | 2006-10-17 |
| 1134213796 | Tristan Vaun Stonger | Oral & Maxillofacial Surgery | 1 S Broadway, Peru, IN 46970-2231 | 2006-10-03 |
| 1558789891 | William Gardner Moll | Oral & Maxillofacial Surgery | 601 W Us Highway 30, Schererville, IN 46375-2656 | 2014-04-03 |
| 1205998739 | John Craig Cook | Oral & Maxillofacial Surgery | 1919 State St, Ste 407, New Albany, IN 47150 | 2006-12-14 |
| 1366512972 | Michael Joseph Deady | Oral & Maxillofacial Surgery | 1630 Poplar St, Terre Haute, IN 47807 | 2006-11-09 |
| 1588733703 | Munster Oral Surgery Inc | Oral & Maxillofacial Surgery | 9250 Columbia Avenue, Suite D 1, Munster, IN 46321 | 2006-11-06 |
| Find all providers with the same taxonomy | ||||
| City | FORT WAYNE |
| Zip Code | 46815 |
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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.