Richard E. Derrick, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

22DI00808700 Issued in NJ

Practice address

3 Mountain Ave
Mendham, NJ 07945-1424

Phone

(973) 543-6666

Fax

(973) 543-5701

NPI assigned

Dec 15, 2006

Last updated

Jul 8, 2007By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Richard E. Derrick, DMD, PA

  • General Practice Dentistry
  • Mendham, NJ
  • NPI 1720140601
  NPD (past) Authorized official

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053473926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 MOUNTAIN AVE",
            "city": "MENDHAM",
            "state": "NJ",
            "postal_code": "079451424",
            "telephone_number": "973-543-6666",
            "fax_number": "973-543-5701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 MOUNTAIN AVE",
            "city": "MENDHAM",
            "state": "NJ",
            "postal_code": "079451424",
            "telephone_number": "973-543-6666",
            "fax_number": "973-543-5701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERRICK",
        "first_name": "RICHARD",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22DI00808700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daytop Village of NJ
• Daytop Village of NJ, Inc.
• Erika Del Vento
• Nicholas Peter Deleeuw, B.A.
• Ruth A Denatale, PHD
• Donna L Devincentis, RPH
• Lynn Dickerson
• David Luke Dijkstra, D.C.
• Dimer Health Services Inc
• Dimerhealth Medical Practice

• Dentist in Mendham, NJ
• Providers in Mendham, NJ by specialty
• Dentist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.