Kylee Rider, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN122458 Issued in GA

Practice address

8590 Bowden St
Douglasville, GA 30134-4525

Phone

(770) 949-1680

NPI assigned

Sep 7, 2021

Sex

Female

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

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 and National Provider Directory roles.

• Eric S Leithner DMD PC

  • General Practice Dentistry
  • Douglasville, GA
  • NPI 1922113554
  NPD (past)
• Howard E Lewis, DDS, PC

  • General Practice Dentistry
  • Douglasville, GA
  • NPI 1750742466
  NPD (past)

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

{
    "created_epoch": "1630972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630972800000",
    "number": "1194494831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8486 CAMPBELLTON ST UNIT 2211",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301330375",
            "telephone_number": "470-626-5735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8590 BOWDEN ST",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301344525",
            "telephone_number": "770-949-1680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIDER",
        "first_name": "KYLEE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-07",
        "last_updated": "2021-09-07",
        "certification_date": "2021-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN122458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peter S Richards, MD
• Ingrid A. Richardson, LPC
• Jatarra Richardson, CNA
• Diana Rico
• Pamela Riddle, PT, DPT
• Kaitlin Riker, PT, DPT
• Sharon Elaine Rinks, PSY.D.
• Rise and Shine EMS LLC
• Rising Hope Therapy LLC
• Rita RX Inc

• General Practice Dentistry in Douglasville, GA
• Providers in Douglasville, GA by specialty
• General Practice Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 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.