Provider Demographics
NPI:1114936838
Name:DENIKE, FREDERICK WILLIAM (DMD)
Entity Type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:WILLIAM
Last Name:DENIKE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 EMERSON PLAZA WEST
Mailing Address - Street 2:
Mailing Address - City:EMERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07630
Mailing Address - Country:US
Mailing Address - Phone:201-599-0001
Mailing Address - Fax:
Practice Address - Street 1:24 EMERSON PLAZA WEST
Practice Address - Street 2:
Practice Address - City:EMERSON
Practice Address - State:NJ
Practice Address - Zip Code:07630
Practice Address - Country:US
Practice Address - Phone:201-599-0001
Practice Address - Fax:201-599-0992
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2020-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJD133801223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice