Provider Demographics
NPI:1255320362
Name:TRIPODI, FRED P (DDS)
Entity Type:Individual
Prefix:DR
First Name:FRED
Middle Name:P
Last Name:TRIPODI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 PHEASANT RUN RD
Mailing Address - Street 2:
Mailing Address - City:PLEASANTVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:10570-2512
Mailing Address - Country:US
Mailing Address - Phone:914-747-0638
Mailing Address - Fax:914-747-5251
Practice Address - Street 1:694 YONKERS AVE
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10704-2622
Practice Address - Country:US
Practice Address - Phone:914-965-3395
Practice Address - Fax:914-423-1457
Is Sole Proprietor?:No
Enumeration Date:2005-10-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0367911223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice