Individual provider Active NPI

Richard Jordan Neal Jr., DMD

  • Dentist
  • Wolfeboro Falls, NH
National Provider Identifier
1295817666
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
1863 Issued in NH
Practice address
190 South Main St
Wolfeboro Falls, NH 03896
Phone
(603) 569-4119
Fax
(603) 569-8605
NPI assigned
Oct 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 1863 NH Primary
Dentist 122300000X 3779 ME

Addresses

Primary practice location

190 South Main St
Wolfeboro Falls, NH 03896

Mailing address

190 South Main St
Wolfeboro Falls, NH 03896
Phone (603) 569-4119

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160518000406 NH Order and Referring Only - DentistPractitioner - Dentist 7810286697

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1863NHMDClinical Social Worker
3779MEMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Richard J. Neal Jr., D.M.D. P.C. Dentist Past 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1295817666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 SOUTH MAIN ST",
            "city": "WOLFEBORO FALLS",
            "state": "NH",
            "postal_code": "03896",
            "telephone_number": "603-569-4119",
            "fax_number": "603-569-8605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 SOUTH MAIN ST",
            "city": "WOLFEBORO FALLS",
            "state": "NH",
            "postal_code": "03896",
            "telephone_number": "603-569-4119",
            "fax_number": "603-569-8605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEAL",
        "first_name": "RICHARD",
        "middle_name": "JORDAN",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-19",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NH",
            "license": "1863",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "ME",
            "license": "3779",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wolfeboro Falls, NH

Sources for this page

Verify at the official NPI Registry.