Individual provider Active NPI

Richard Cary Richter, DMD

  • General Practice Dentistry
  • East Patchogue, NY
National Provider Identifier
1003912965
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
041854 Issued in NY
Practice address
680 S Country Rd
East Patchogue, NY 11772-5551
Phone
(631) 475-1191
Fax
(631) 758-5351
NPI assigned
Sep 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 041854 NY Primary

Addresses

Primary practice location

680 S Country Rd
East Patchogue, NY 11772-5551

Mailing address

16 Polo Grounds LN
East Quogue, NY 11942-3631
Phone (631) 653-9028

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190201000713 NY Order and Referring Only - DentistPractitioner - Dentist 5496092272

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
041854NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Patchogue Family Dental, PC General Practice CurrentSince Sep 6, 1991 Accepting new patients

Locations

680 S Country Rd
East Patchogue, NY 11772
Phone (631) 475-1191

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1003912965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 POLO GROUNDS LN",
            "city": "EAST QUOGUE",
            "state": "NY",
            "postal_code": "119423631",
            "telephone_number": "631-653-9028",
            "fax_number": "631-653-9078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "680 S COUNTRY RD",
            "city": "EAST PATCHOGUE",
            "state": "NY",
            "postal_code": "117725551",
            "telephone_number": "631-475-1191",
            "fax_number": "631-758-5351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHTER",
        "first_name": "RICHARD",
        "middle_name": "CARY",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "041854",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Patchogue, NY

Sources for this page

Verify at the official NPI Registry.