Healthcare Provider Details

I. General information

NPI: 1922011337
Provider Name (Legal Business Name): JAMES TERRY FREY DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2006
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

623 N STATE STREET
NORTH VERNON IN
47265
US

IV. Provider business mailing address

PO BOX 1008
NORTH VERNON IN
47265-5008
US

V. Phone/Fax

Practice location:
  • Phone: 812-346-6884
  • Fax: 812-346-6884
Mailing address:
  • Phone: 812-346-6884
  • Fax: 812-346-1717

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License NumberDB-2025-0516
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number12006939
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: