Provider Demographics
NPI:1770651333
Name:FREIDEN, DENIS IAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:DENIS
Middle Name:IAN
Last Name:FREIDEN
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 1:725 W BROOKHAVEN CIR
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38117-4503
Mailing Address - Country:US
Mailing Address - Phone:901-761-2210
Mailing Address - Fax:
Practice Address - Street 1:725 W BROOKHAVEN CIR
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38117-4503
Practice Address - Country:US
Practice Address - Phone:901-761-2210
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS4200122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist