Individual provider Active NPI

Markus Richard, DMD

  • Dentist
  • St Johnsbury, VT
National Provider Identifier
1093282972
Registry record updated May 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DE61250032 Issued in WA
Practice address
1 Place Notre Dame # 1
St Johnsbury, VT 05819-2521
Phone
(802) 748-9357
NPI assigned
Oct 29, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 30, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN23802 FL
Dentist 122300000X DE61250032 WA Primary

Addresses

Primary practice location

1 Place Notre Dame # 1
St Johnsbury, VT 05819-2521

Mailing address

20591 Ardore LN
Estero, FL 33928-6381
Phone (239) 834-7178

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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

Enrollment IDStateProvider typePAC IDDetails
I20230731003488 WA Order and Referring Only - DentistPractitioner - Dentist 3971964453

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN23802FLMDDentist
DE61250032WAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Nek Dental Medicine PLLC Dentist Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1540771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685404800000",
    "number": "1093282972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20591 ARDORE LN",
            "city": "ESTERO",
            "state": "FL",
            "postal_code": "339286381",
            "telephone_number": "239-834-7178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 PLACE NOTRE DAME # 1",
            "city": "ST JOHNSBURY",
            "state": "VT",
            "postal_code": "058192521",
            "telephone_number": "802-748-9357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARD",
        "first_name": "MARKUS",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-10-29",
        "last_updated": "2023-05-30",
        "certification_date": "2023-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN23802",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE61250032",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Johnsbury, VT

Sources for this page

Verify at the official NPI Registry.