Individual provider Active NPI

Brian Riegel, DDS

  • Dentist
  • Alexandria, MN
National Provider Identifier
1003545393
Registry record updated Jun 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D14764 Issued in MN
Practice address
2209 Jefferson St Ste 101a
Alexandria, MN 56308-4843
Phone
(320) 815-5711
Fax
(320) 335-2619
NPI assigned
Jun 10, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D14764 MN Primary

Addresses

Primary practice location

2209 Jefferson St Ste 101a
Alexandria, MN 56308-4843

Mailing address

2209 Jefferson St
Alexandria, MN 56308-4843
Phone (320) 815-5711

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
D14764MNMDDentist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1654819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654819200000",
    "number": "1003545393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2209 JEFFERSON ST",
            "city": "ALEXANDRIA",
            "state": "MN",
            "postal_code": "563084843",
            "telephone_number": "320-815-5711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2209 JEFFERSON ST STE 101A",
            "city": "ALEXANDRIA",
            "state": "MN",
            "postal_code": "563084843",
            "telephone_number": "320-815-5711",
            "fax_number": "320-335-2619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIEGEL",
        "first_name": "BRIAN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-10",
        "last_updated": "2022-06-10",
        "certification_date": "2022-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D14764",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.