Individual provider Active NPI

Jared Michael Richard, DDS

  • General Practice Dentistry
  • Harrisburg, PA
National Provider Identifier
1083141055
Registry record updated Apr 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DS041648 Issued in PA
Practice address
4700 Union Deposit Rd Ste 210
Harrisburg, PA 17111-3774
Phone
(717) 510-1309
NPI assigned
May 22, 2017
Last updated
Apr 11, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2019

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 DS041648 PA Primary

Addresses

Primary practice location

4700 Union Deposit Rd Ste 210
Harrisburg, PA 17111-3774

Mailing address

4700 Union Deposit Rd Ste 210
Harrisburg, PA 17111-3774
Phone (717) 545-2003

Other practice location 1

3401 Hartzdale Dr Ste 122
Camp Hill, PA 17011-7238
Phone (717) 775-6208

Other practice location 2

8 Brookwood Ave Ste B
Carlisle, PA 17015-9173
Phone (717) 245-2258

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
DS041648PAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Apex Dental Smiles Corp. General Practice Past Accepting new patients
Barry a Sherman, DDS General Practice Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1495411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554940800000",
    "number": "1083141055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 UNION DEPOSIT RD STE 210",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171113774",
            "telephone_number": "717-545-2003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 UNION DEPOSIT RD STE 210",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171113774",
            "telephone_number": "717-510-1309"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3401 Hartzdale Dr Ste 122",
            "address_purpose": "LOCATION",
            "city": "Camp Hill",
            "state": "PA",
            "postal_code": "170117238",
            "country_code": "US",
            "telephone_number": "717-775-6208",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8 Brookwood Ave Ste B",
            "address_purpose": "LOCATION",
            "city": "Carlisle",
            "state": "PA",
            "postal_code": "170159173",
            "country_code": "US",
            "telephone_number": "717-245-2258",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RICHARD",
        "first_name": "JARED",
        "middle_name": "MICHAEL",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-22",
        "last_updated": "2019-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS041648",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Harrisburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2019; 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.