Individual provider Active NPI

Jansen Richins

  • General Practice Dentistry
  • Edmond, OK
National Provider Identifier
1073763975
Registry record updated Sep 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
6014 Issued in OK
Practice address
17420 Mercury LN
Edmond, OK 73012-7069
Phone
(705) 216-3752
NPI assigned
Sep 27, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2008

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 6014 OK Primary

Addresses

Primary practice location

17420 Mercury LN
Edmond, OK 73012-7069

Mailing address

17420 Mercury LN
Edmond, OK 73012-7069

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6014OKMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1222473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222473600000",
    "number": "1073763975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17420 MERCURY LN",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730127069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17420 MERCURY LN",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730127069",
            "telephone_number": "705-216-3752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHINS",
        "first_name": "JANSEN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-27",
        "last_updated": "2008-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OK",
            "license": "6014",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edmond, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2008; 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.