Individual provider Active NPI

David Nathan Rickey, DDS

  • Dentist
  • San Antonio, TX
National Provider Identifier
1205811452
Registry record updated Jun 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
10543 Issued in TX
Practice address
1 Haven for Hope Way
BLDG. #1, Suite 400
San Antonio, TX 78207-1108
Phone
(210) 220-2322
Fax
(210) 220-2311
NPI assigned
Dec 9, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 10543 TX Primary

Addresses

Primary practice location

1 Haven for Hope Way
BLDG. #1, Suite 400
San Antonio, TX 78207-1108

Mailing address

1 Haven for Hope Way
BLDG. #1, Suite 400
San Antonio, TX 78207-1108
Phone (210) 220-2322

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10543TXMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1134086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370736000000",
    "number": "1205811452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 HAVEN FOR HOPE WAY",
            "address_2": "BLDG. #1, SUITE 400",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782071108",
            "telephone_number": "210-220-2322",
            "fax_number": "210-220-2311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HAVEN FOR HOPE WAY",
            "address_2": "BLDG. #1, SUITE 400",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782071108",
            "telephone_number": "210-220-2322",
            "fax_number": "210-220-2311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICKEY",
        "first_name": "DAVID",
        "middle_name": "NATHAN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-09",
        "last_updated": "2013-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "10543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2013; 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.