IndividualActive
Jack Fredrickson, D.D.S.
NPI 1427017979 · General Practice Dentistry · Lake Havasu City, AZ
Jack Fredrickson, D.D.S. is a General Practice Dentistry provider in Lake Havasu City, AZ (NPI 1427017979).
Provider details
- NPI number
- 1427017979
- Entity type
- Individual
- Primary specialty
- General Practice DentistryDental Providers
- Credential
- D.D.S.
- Sex
- Male
- License
- 2079 (AZ)
Specialties & taxonomies
Dental Providers
Profile Score
Detailed profile(91/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
20 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1930 Mesquite Ave
Ste. 8
Lake Havasu City, AZ 86403-5674
Phone: (928) 855-4347
Fax: (928) 855-6894
Street-level locationGet directions
Mailing address
2061 Bryce Cir
Lake Havasu City, AZ 86406-8352
Registry dates
- Enumerated
- 2006-03-22
- Last updated
- 2007-07-08
Frequently asked questions
- What is Jack Fredrickson's NPI number?
- Jack Fredrickson's National Provider Identifier (NPI) is 1427017979, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Jack Fredrickson's specialty?
- Jack Fredrickson is listed in the NPPES registry with a primary specialty of General Practice Dentistry (Dental Providers).
- Where is Jack Fredrickson located?
- Jack Fredrickson's practice location on file with NPPES is 1930 Mesquite Ave, Lake Havasu City, AZ 86403-5674.
- What is Jack Fredrickson's phone number?
- The practice phone number listed in the NPPES registry for Jack Fredrickson is (928) 855-4347.
- Is Jack Fredrickson's NPI active?
- Yes — Jack Fredrickson's NPI (1427017979) is active in the NPPES registry as of the last update on 2007-07-08.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.