George Shackelford Richardson II, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

14684 Issued in TX

Practice address

16000 Preston Rd
#300
Dallas, TX 75248-3567

Phone

(972) 490-6268

Fax

(972) 490-0111

NPI assigned

Mar 30, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1265552368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16000 PRESTON RD",
            "address_2": "#300",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752483567",
            "telephone_number": "972-490-6268",
            "fax_number": "972-490-0111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16000 PRESTON RD",
            "address_2": "#300",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752483567",
            "telephone_number": "972-490-6268",
            "fax_number": "972-490-0111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARDSON",
        "first_name": "GEORGE",
        "middle_name": "SHACKELFORD",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "14684",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KS",
            "license": "5965",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NM",
            "license": "1514",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "D14684",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christopher Richardson
• Christy R Richardson, CRNA
• Cody Ryan Richardson, DPT
• Diana E Richardson, LMSW
• Eunise O Richardson, LPCI
• Herndon Richardson Jr., PA-C
• Janayia Richardson, FNP-C
• Kaitlyn Richardson
• Lacy Cheyenne Richardson, COTA
• Laura Richardson, PHARMD

• Dentist in Dallas, TX
• Providers in Dallas, TX by specialty
• Dentist in Texas

• 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.