Individual provider · Type 1 NPI

Jack C. Fredrickson, DDS

General Practice Dentistry · Lake Havasu City, AZ

NPI number 1427017979 Active

Practice location

1930 Mesquite Ave, Ste. 8
Lake Havasu City, AZ 86403-5674

Call (928) 855-4347 Map

Fax (928) 855-6894

Mailing address

2061 Bryce Cir
Lake Havasu City, AZ 86406-8352

Specialties and licenses

TaxonomyCodeLicense
General Practice Dentistry Primary 1223G0001X2079 (AZ)

General Practice Dentistry: A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

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About NPI 1427017979

Jack C. Fredrickson, DDS's National Provider Identifier is 1427017979, issued on Mar 22, 2006. The primary taxonomy on file is General Practice Dentistry (1223G0001X), and the practice location is in Lake Havasu City, AZ. The record was last updated on Jul 13, 2026.