Active NPI
David Warren Richards, DDS, PHD
- Periodontics
- San Diego, CA
National Provider Identifier
1285658203
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 39876
- Practice address
- 4060 4TH Ave
Suite 303
San Diego, CA 92103-2116 - Phone
- (619) 543-0905
- Fax
- (619) 543-0422
- NPI assigned
- Jul 26, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 39876 | CA | Primary |
Addresses
Primary practice location
4060 4TH Ave
Suite 303
San Diego, CA 92103-2116
Mailing address
4060 4TH Ave
Suite 303
San Diego, CA 92103-2116
Phone (619) 543-0905
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 39876 | CA | MD | Geriatric Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| David W Richards, DDS, PHD | Periodontics | Past | Accepting new patients |
| Kennie Kwok DMD, Inc | Periodontics | 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.
-
- Periodontics
- San Diego, CA
- NPI 1659584670
-
- Periodontics
- San Diego, CA
- NPI 1073966057
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1285658203",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4060 4TH AVE",
"address_2": "SUITE 303",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921032116",
"telephone_number": "619-543-0905",
"fax_number": "619-543-0422"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4060 4TH AVE",
"address_2": "SUITE 303",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921032116",
"telephone_number": "619-543-0905",
"fax_number": "619-543-0422"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RICHARDS",
"first_name": "DAVID",
"middle_name": "WARREN",
"name_prefix": "Dr.",
"credential": "DDS, PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "CA",
"license": "39876",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
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.