Active NPI
Richard Carl Rissel, D.M.D.
- Pediatric Dentistry
- Concord, CA
National Provider Identifier
1245237023
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 26516
- Practice address
- 2875 Willow Pass Rd
Concord, CA 94519-2553 - Phone
- (925) 689-2800
- Fax
- (925) 689-2310
- NPI assigned
- Jul 7, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 26516 | CA | Primary |
Addresses
Primary practice location
2875 Willow Pass Rd
Concord, CA 94519-2553
Mailing address
2875 Willow Pass Rd
Concord, CA 94519-2553
Phone (925) 689-2800
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| B26516-01 | Other | CA | DENTICAL |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26516 | CA | MD | Pediatric Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| DO DDS Corp | Pediatric Dentistry | Past | Accepting new patients |
| Jason M. Renner DDS Apc | Pediatric Dentistry | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Pediatric Dentistry
- Concord, CA
- NPI 1588818363
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1120694400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1197417600000",
"number": "1245237023",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2875 WILLOW PASS RD",
"city": "CONCORD",
"state": "CA",
"postal_code": "945192553",
"telephone_number": "925-689-2800",
"fax_number": "925-689-2310"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2875 WILLOW PASS RD",
"city": "CONCORD",
"state": "CA",
"postal_code": "945192553",
"telephone_number": "925-689-2800",
"fax_number": "925-689-2310"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RISSEL",
"first_name": "RICHARD",
"middle_name": "CARL",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-07-07",
"last_updated": "2007-12-12",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "CA",
"license": "26516",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DENTICAL",
"identifier": "B26516-01",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Concord, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 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.