MEDICARE: MATTHEW FRYKENBERG

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program
2	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	DN10000619	MA

General Provider Information

NPI Number	:	1295276954
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MATTHEW FRYKENBERG

Provider Business Mailing Address
First Line	:	5 APPLETREE LN
Second Line	:
City	:	ANDOVER
State	:	MA
Zip	:	01810-4101
Country	:	US
Telephone Number	:	978-494-2853
Fax Number	:

Provider Business Practice Location Address
First Line	:	555 TURNPIKE ST STE 41A
Second Line	:
City	:	NORTH ANDOVER
State	:	MA
Zip	:	01845-5935
Country	:	US
Telephone Number	:	789-926-3421
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/14/2017
Last Update Date	:	07/16/2025

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Directions to “ MATTHEW FRYKENBERG ” Practice Location

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