Reynaldo Christy Riboul, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

DN1858876 Issued in MA

Practice address

12 Grant St Unit 2
Dorchester, MA 02125-1223

Phone

(347) 217-7963

NPI assigned

May 26, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1590451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606780800000",
    "number": "1073136933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 GRANT ST UNIT 2",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "021251223",
            "telephone_number": "347-217-7963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 GRANT ST UNIT 2",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "021251223",
            "telephone_number": "347-217-7963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIBOUL",
        "first_name": "REYNALDO",
        "middle_name": "CHRISTY",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-05-26",
        "last_updated": "2020-12-01",
        "certification_date": "2020-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "DN1858876",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL LICENSE NUMBER",
            "identifier": "DN1858876",
            "state": "MA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "rrcr5092@gmail.com",
            "affiliation": "N",
            "address_1": "12 Grant St Unit 2",
            "city": "Dorchester",
            "state": "MA",
            "country_code": "US",
            "postal_code": "021251223",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Denise Reynoso, MSW
• Abigail Rose Rezendes, FNP
• Leonel Rezil, RN
• Elizabeth Anne Rhodes, RN
• Megan Ribak, MS, OTR/L
• Venice Inez Rice-Bell, RN
• Carlotta Richardson
• Kyle Richardson, BACHELOR OF ARTS
• Rebecca Kathryn Richendollar, LCSW
• Ashari Rosemarie Ricketts

• Dentist in Dorchester, MA
• Providers in Dorchester, MA by specialty
• Dentist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2020; 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.