Cody Richardson, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12014117A Issued in IN

Practice address

612 S Detroit St
Lagrange, IN 46761-2314

Phone

(260) 463-2111

NPI assigned

Jun 2, 2023

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1685664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685664000000",
    "number": "1114610201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7075 N 850 E",
            "city": "HOWE",
            "state": "IN",
            "postal_code": "467469598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 S DETROIT ST",
            "city": "LAGRANGE",
            "state": "IN",
            "postal_code": "467612314",
            "telephone_number": "260-463-2111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARDSON",
        "first_name": "CODY",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-02",
        "last_updated": "2023-06-02",
        "certification_date": "2023-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12014117A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kari Ann Rader, NP
• Rebekah A Rakoczy, NP-C
• Redi-Care Inc P C
• Renaissance Ocular Disease and Trauma Foundation, Inc.
• Kelli Marie Rhodes, PMHNP-BC
• Bianca Rivera
• Ross R Robison, PHARMD
• Sarah Janine Rodriguez Helm
• Ronald L. Denton, DDS, PC
• Kristy Jo Roth, PHARMD

• General Practice Dentistry in Lagrange, IN
• Providers in Lagrange, IN by specialty
• General Practice Dentistry in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2023; 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.