Healthcare Provider Details

I. General information

NPI: 1689609034
Provider Name (Legal Business Name): TROY A FRAZEE MD DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7232 PEARL RD
MIDDLEBURG HTS OH
44130
US

IV. Provider business mailing address

7232 PEARL RD
MIDDLEBURG HTS OH
44130
US

V. Phone/Fax

Practice location:
  • Phone: 440-845-0555
  • Fax: 440-845-4556
Mailing address:
  • Phone: 440-845-0555
  • Fax: 440-845-4556

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number30019942
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code204E00000X
TaxonomyOral & Maxillofacial Surgery (D.M.D.)
License Number35080359
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: