Richard E. Howell III, D.D.S

Individual provider Active NPI Dentist · Lordsburg, NM

NPI 1104948355 · NPPES record last updated Mar 26, 2018

Key facts

NPI
1104948355
Entity type
Individual (NPI type 1)
Primary specialty
Dentist 122300000X
License
DD4446 (NM)
Practice address
530 De Moss St
Lordsburg, NM 88045-2618
Phone
(575) 542-8384
Fax
(575) 542-8387
NPI assigned
Apr 6, 2007
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NM
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20160428001161 NM Order and Referring Only - Dentist
Practitioner - Dentist
7517266372

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
072863IAMDDentist
DD4446NMMDDentist

Interoperability endpoints

  • Direct secure messaging: richard.howell.p29@direct.fhn-fqhc.nextgenshare.com

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 072863 IA
Dentist 122300000X DD4446 NM Yes

Addresses

Primary practice location

530 De Moss St
Lordsburg, NM 88045-2618

Mailing address

PO Drawer PH
Chinle, AZ 86503
Phone (928) 674-7001

Other identifiers

IdentifierTypeStateIssuer
528218MedicaidAZ

Other providers in Lordsburg, NM

All providers in Lordsburg, NM · Dentist in New Mexico

Sources for this page

Verify at the official NPI Registry.