Kevin J Risko, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS039293 Issued in PA

Practice address

326 Portland PL
Lititz, PA 17543-7705

Phone

(717) 320-4963

NPI assigned

Oct 4, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in PA

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726012800000",
    "number": "1053406132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "326 PORTLAND PL",
            "city": "LITITZ",
            "state": "PA",
            "postal_code": "175437705",
            "telephone_number": "717-320-4963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "326 PORTLAND PL",
            "city": "LITITZ",
            "state": "PA",
            "postal_code": "175437705",
            "telephone_number": "717-320-4963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RISKO",
        "first_name": "KEVIN",
        "middle_name": "J",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2024-09-11",
        "certification_date": "2024-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS039293",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102770945",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robert T Richards, CRNP
• Ride2Care Inc
• Alice E Riden, MD
• Scott T. Riebel, MD
• Ashley Riehl
• Catherine Rivera
• Jennifer L. Robertshaw, M.D.
• Lesley Rodono, LMT
• Roger K Fretz P H D Inc
• Shelley A Rohde, CNM

• General Practice Dentistry in Lititz, PA
• Providers in Lititz, PA by specialty
• General Practice Dentistry in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.