Mark Alan Richardson, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

34204 Issued in CA

Practice address

2330 Truxtun Ave
Ste. B
Bakersfield, CA 93301-3500

Phone

(661) 323-2003

Fax

(661) 328-0253

NPI assigned

Jan 11, 2007

Last updated

Jul 8, 2007By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104976067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2305 CHINON ST",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933112103",
            "telephone_number": "661-665-8612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2330 TRUXTUN AVE",
            "address_2": "STE. B",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933013500",
            "telephone_number": "661-323-2003",
            "fax_number": "661-328-0253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARDSON",
        "first_name": "MARK",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "34204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shyanna Richards
• Amelda (Amy) J. Richardson, MED, MA
• Eva Marie Richardson
• Leni Richardson, VN237400
• Malachi Richardson
• Tareia Marie Richardson
• Setiva Marie Richee-Eastland, LCSW
• Nolan E Richert
• Rasheda Richmond, RN
• Leroy Neal Rickard, LMFT 125024

• General Practice Dentistry in Bakersfield, CA
• Providers in Bakersfield, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.