Jack C. Fredrickson, D.D.S.
General Practice Dentistry · Lake Havasu City, AZ
Jack C. Fredrickson, D.D.S. is a general practice dentistry with a practice address in Lake Havasu City, Arizona, and NPI 1427017979, issued on Mar 22, 2006. Check the license (Arizona 2079, as entered in NPPES) with the Arizona board that licenses this profession; the federal record below is the public data PlainDoctor holds for this provider.
- Name
- Jack C. Fredrickson
- Credential
- D.D.S.
- Primary taxonomy
- General Practice Dentistry 1223G0001X
- License number
- 2079 AZ
Self-reported in NPPES; status is on the state search - Practice location
- 1930 Mesquite Ave, Lake Havasu City, AZ 86403
- Phone
- (928) 855-4347
- Enumerated
- Mar 22, 2006
- Record last updated
- Jul 13, 2026
- Fax
- (928) 855-6894
- Entity
- Type 1 · individual
Also registered at 1930 Mesquite Ave
A shared address usually means a shared clinic or building; it does not show who employs whom.
- Beth Goldstein, LCSWClinical Social Worker1508914870
- Mark Heiser, HISHearing Instrument Specialist1619449477
- Molly Port, LPCProfessional Counselor1124431101
Verify Jack C. Fredrickson in five checks
- 1IdentityNPI record in CMS NPPESNPI lookupConfirmed in NPPES
- 2LicenseActive license and public ordersWhich Arizona board licenses this profession
Search for license 2079Check the board - 3Other statesLicenses and actions elsewhereDocInfo (FSMB)Not checked
- 4ExclusionsMedicare and Medicaid bansHHS-OIG exclusion listNot checked
- 5CertificationBoard certificationABMS AOA NCCPA AANPNot checked
20 general practice dentistry records list a practice address in Lake Havasu City
They are 20 of the 626 NPPES records with a practice address in Lake Havasu City, and 2,482 general practice dentistry records in Arizona. No Medicare prescribing, quality score, industry payment or hospital affiliation is published for this NPI.
All 20 in Lake Havasu City → All 2,482 in Arizona → Every provider in Lake Havasu City →
Other general practice dentistry records in Arizona
- Bruce Aahrens, DDSPeoria, AZ1356428510
- Abraham Abaie, DDSScottsdale, AZ1477641256
- Alisha Abbas, DMDTucson, AZ1528985355
- Ali AbdulmajeedLaveen, AZ1194493080
- Reza Abedi, DDSApache Junction, AZ1578659736
- Aryan Abedini, DMDAvondale, AZ1841776150
- Ramez Abilmona, DMDMesa, AZ1376744748
- Mark AbzugPhoenix, AZ1871648543
- Chad Achatz, DMDScottsdale, AZ1699220863
- Kelsey Adams, DMDScottsdale, AZ1770476731
Common questions
What is Jack C. Fredrickson, D.D.S.'s NPI number?
Jack C. Fredrickson, D.D.S.'s National Provider Identifier (NPI) is 1427017979, issued on Mar 22, 2006. An NPI identifies a provider in billing; it is not a license.
Where is Jack C. Fredrickson, D.D.S. located?
The NPPES record lists a practice address at 1930 Mesquite Ave, Lake Havasu City, AZ, 86403. Phone: (928) 855-4347. Providers update this record themselves, so call before visiting.
How can I verify Jack C. Fredrickson, D.D.S.'s license?
NPPES lists Arizona license number 2079, as entered by the provider. Search the Arizona board that licenses this profession; the NPPES record confirms identity only.
Source: CMS National Plan and Provider Enumeration System (NPPES), file of Aug 9, 2026 (NPPES files on CMS.gov); NUCC Health Care Provider Taxonomy. An NPI identifies who bills; it is not a license.
Figures on PlainDoctor are read from the federal files each page names (CMS NPPES, Medicare Part D, MIPS, Open Payments; the HHS-OIG exclusion list only as counts) and from Census population estimates, with the file date shown beside them. See our editorial standards & corrections policy, the methodology behind these numbers, or report a data error. Data current as of Aug 9, 2026.