Healthcare Provider Details

I. General information

NPI: 1174018709
Provider Name (Legal Business Name): MEGAN MARIE FREW DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2018
Last Update Date: 07/03/2026
Certification Date: 07/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6895 BURLINGTON PIKE
FLORENCE KY
41042-1576
US

IV. Provider business mailing address

1712 GRANDMERE LN
CINCINNATI OH
45206-2191
US

V. Phone/Fax

Practice location:
  • Phone: 859-344-1185
  • Fax: 859-344-1210
Mailing address:
  • Phone: 502-693-3003
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number30.025908
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number10161
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: