Dr. Joseph Derek Fridgen
Pediatric Dentist
189 N Bascom Ave Ste 200
San Jose
, California 95128-1869
Dr. Joseph Derek Fridgen
Pediatric Dentist
189 N Bascom Ave Ste 200
San Jose
, California 95128-1869
(408) 286-6319
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About
Features
Specialties
- Pediatric Dentist
Languages spoken
- English
Location
First Address
- Dr. Joseph Derek Fridgen
- 189 N Bascom Ave Ste 200
- San Jose, CA
- Zip : 95128-1869
- Fax : (408) 286-6319
- Phone : (408) 286-6315
Second Address
- Dr. Joseph Derek Fridgen
- 189 N Bascom Ave Ste 200
- San Jose, CA
- Zip : 95128-1869
- Fax : (408) 286-6319
- Phone : (408) 286-6315
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 1223P0221X | Pediatric Dentist | 50909 | CA |
National Provider Identifier
| NPI | 1003980194 |
|---|---|
| Provider Name | Dr. Joseph Derek Fridgen |
| First Address | San Jose, CA 95128-1869 |
| Second Address | San Jose, CA 95128-1869 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 20/11/2006 |
| Last Update Date | 08/07/2007 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.