Kori Marie Richardson, RDH

Primary specialty

Dental HygienistTaxonomy code 124Q00000X

License

13008766A Issued in IN

Practice address

57250 Alpha Dr
Goshen, IN 46528-7804

Phone

(574) 875-3817

NPI assigned

Jun 25, 2021

Last updated

Jun 25, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Kori Marie Miller Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Springer Dental Care at Crossroads LLC

  • Dental Clinic/Center
  • Goshen, IN
  • NPI 1306305446
  NPD (past)

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

{
    "created_epoch": "1624579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624579200000",
    "number": "1134799935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50782 COBBLESTONE DR",
            "city": "GRANGER",
            "state": "IN",
            "postal_code": "465301309",
            "telephone_number": "574-220-2859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57250 ALPHA DR",
            "city": "GOSHEN",
            "state": "IN",
            "postal_code": "465287804",
            "telephone_number": "574-875-3817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARDSON",
        "first_name": "KORI",
        "middle_name": "MARIE",
        "credential": "RDH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-25",
        "last_updated": "2021-06-25",
        "certification_date": "2021-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "IN",
            "license": "13008766A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL HYGIENE LICENSE NUMBER",
            "identifier": "13008766A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KORI",
            "last_name": "MILLER",
            "middle_name": "MARIE",
            "credential": "RDH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Emily Repaich
• Julianne Repczynski, MSW
• Diane Resnik, FNP-BC
• Kristan M Rheinheimer, N.P.
• Alyssa Richardson
• Leah Kathryn Richardson, FNP-BC
• Jeffrey Richmond, APN
• Whitney M Richmond, DDS
• Michelle Elizabeth Ridenour, AU.D
• Yvonne Renee Riege, LCAC

• Dental Hygienist in Goshen, IN
• Providers in Goshen, IN by specialty
• Dental Hygienist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2021; 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.