Individual provider Active NPI

Mark Allen Riegel, DMD

  • General Practice Dentistry
  • Arvada, CO
National Provider Identifier
1013933555
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
9180 Issued in CO
Practice address
8795 Ralston Rd Ste 104
Arvada, CO 80002-2353
Phone
(303) 424-2222
Fax
(303) 423-2066
NPI assigned
Jul 15, 2006
Sex
Male
Sole proprietor
Yes

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 9180 CO Primary

Addresses

Primary practice location

8795 Ralston Rd Ste 104
Arvada, CO 80002-2353

Mailing address

8795 Ralston Rd Ste 104
Arvada, CO 80002-2353
Phone (303) 424-2222

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20150507000817 CO Order and Referring Only - DentistPractitioner - Dentist 5496074718

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9180COMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1013933555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8795 RALSTON RD STE 104",
            "city": "ARVADA",
            "state": "CO",
            "postal_code": "800022353",
            "telephone_number": "303-424-2222",
            "fax_number": "303-423-2066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8795 RALSTON RD STE 104",
            "city": "ARVADA",
            "state": "CO",
            "postal_code": "800022353",
            "telephone_number": "303-424-2222",
            "fax_number": "303-423-2066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIEGEL",
        "first_name": "MARK",
        "middle_name": "ALLEN",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "9180",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arvada, CO

Sources for this page

Verify at the official NPI Registry.