Provider Demographics
NPI:1053559450
Name:DEPEKARY, FREDERICK GEZA (DMD)
Entity type:Individual
Prefix:
First Name:FREDERICK
Middle Name:GEZA
Last Name:DEPEKARY
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 1:82 HELEN AVE
Mailing Address - Street 2:
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728-2623
Mailing Address - Country:US
Mailing Address - Phone:732-845-2273
Mailing Address - Fax:
Practice Address - Street 1:82 HELEN AVE
Practice Address - Street 2:
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728-2623
Practice Address - Country:US
Practice Address - Phone:732-845-2273
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-23
Last Update Date:2009-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI190651223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice