Frederick Anthony Fenderson, DDS
Frederick Anthony Fenderson is a Orthodontics and Dentofacial Orthopedics Dentistry provider (Dentist) practicing in Prescott, AZ, registered in the NPPES registry with NPI 1619081064 since 2006. The credential DDS stands for Doctor of Dental Surgery.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1619081064 |
|---|---|
| Entity type | Individual (Type 1) |
| Name | Frederick Anthony Fenderson |
| Credential | DDS |
| Sex | Male |
| Practice address | 3150 CLEARWATER DR, Prescott, AZ, 86305 |
| Phone | 9284457051 |
| Fax | 9287781731 |
| Enumeration date | 2006-08-19 |
| Last updated in NPPES | 2007-07-08 |
Taxonomy & licenses
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 1223X0400X | Orthodontics and Dentofacial Orthopedics Dentistry | Secondary | 42820 | CA |
| 1223X0400X | Orthodontics and Dentofacial Orthopedics Dentistry | Primary | D-4566 | AZ |
DDS — Doctor of Dental Surgery: A licensed dentist; DDS and DMD are equivalent dental degrees. About the DDS credential
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 589393 | Other | AZ | ACCESS |
Copy-ready billing details
Provider: Frederick Fenderson, DDS NPI: 1619081064 Taxonomy: 1223X0400X (Orthodontics and Dentofacial Orthopedics Dentistry) Address: 3150 CLEARWATER DR, Prescott, AZ, 86305
Other providers at this practice address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1457168288 | Allen Sara | Individual | Orthodontics and Dentofacial Orthopedics Dentistry | Prescott, AZ |
Verify this record
Cross-check NPI 1619081064 against the authoritative CMS record: view Frederick Anthony Fenderson on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
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Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2007-07-08.