Individual provider Active NPI

Richard Raab, DDS

  • General Practice Dentistry
  • Fort Collins, CO
National Provider Identifier
1225135809
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5163 Issued in CO
Practice address
1136 E Stuart St
Suite #3140
Fort Collins, CO 80525-1195
Phone
(979) 048-2152
NPI assigned
Sep 17, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 5163 CO Primary

Addresses

Primary practice location

1136 E Stuart St
Suite #3140
Fort Collins, CO 80525-1195

Mailing address

1136 E Stuart St
Suite #3140
Fort Collins, CO 80525-1195
Phone (979) 048-2152

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
5163COMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Dental Sleep Medicine, Inc PastSince Dec 24, 2016 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1158451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1225135809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1136 E STUART ST",
            "address_2": "SUITE #3140",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805251195",
            "telephone_number": "979-048-2152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1136 E STUART ST",
            "address_2": "SUITE #3140",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805251195",
            "telephone_number": "979-048-2152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAAB",
        "first_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "5163",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

  • 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.