MEDICARE: DR. JOEL FRAND D.D.S.

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	1223G0001X	General Practice Dentistry	22136	TX
2	122300000X	Dentist	DN19603	FL
3	122300000X	Dentist	DEN5313	DC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1568675866
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOEL FRAND D.D.S.

Provider Business Mailing Address
First Line	:	17325 NE 10TH AVE
Second Line	:
City	:	NORTH MIAMI BEACH
State	:	FL
Zip	:	33162-2605
Country	:	US
Telephone Number	:	305-915-5744
Fax Number	:	305-915-5744

Provider Business Practice Location Address
First Line	:	17325 NE 10TH AVE
Second Line	:
City	:	NORTH MIAMI BEACH
State	:	FL
Zip	:	33162-2605
Country	:	US
Telephone Number	:	305-915-5744
Fax Number	:	305-915-5744

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

Provider Enumeration Date	:	05/07/2007
Last Update Date	:	07/06/2012

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