Douglas W Rietz, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DE00006530 Issued in WA

Practice address

208 S Park St
Walla Walla, WA 99362-3247

Phone

(509) 522-0499

Fax

(509) 522-0593

NPI assigned

Nov 6, 2006

Sex

Male

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 3

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.

• Rietz Dental Management Corporation

  • General Practice Dentistry
  • Walla Walla, WA
  • NPI 1295947463
  NPD (past) Authorized official

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1265501233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 S PARK ST",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993623247",
            "telephone_number": "509-522-0499",
            "fax_number": "509-522-0593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 S PARK ST",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993623247",
            "telephone_number": "509-522-0499",
            "fax_number": "509-522-0593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIETZ",
        "first_name": "DOUGLAS",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE00006530",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WASHINGTON DENTAL SVC",
            "identifier": "56530",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "00762606",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5017033",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Merilee J Richardson, MSW, LICSW
• Calvin J Rick, MD
• Wayne Rickords
• Kristen M Riegert, MD
• Rietz Dental Management Corporation
• Andrew Riley
• Lara Ann Riley, PH.D.
• Omar Rivera
• RJJ Inc
• Road Runner Express Inc.

• General Practice Dentistry in Walla Walla, WA
• Providers in Walla Walla, WA by specialty
• General Practice Dentistry in Washington

• 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.