Raymond Leroy Wright Jr., DDS

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

63063 Issued in CA

Practice address

1001 Avenida Pico Ste K
San Clemente, CA 92673-6956

Phone

(949) 361-4867

Fax

(949) 361-4868

NPI assigned

Aug 12, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Dr. Raymond Leroy Wright, Jr DDS PC Professional name

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rwright@direct.westerndental.com

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.

• Raymond L. Wright Jr DDS PC

  • Periodontics
  • San Clemente, CA
  • NPI 1740868140
  NPD Authorized official
• Dr. Alice P. Moran, DMD, Apc

  • Dental Clinic/Center
  • San Clemente, CA
  • NPI 1295890994
  NPD (past)

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

{
    "created_epoch": "1123804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620777600000",
    "number": "1316949902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 AVENIDA PICO STE K",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926736956",
            "telephone_number": "949-361-4867",
            "fax_number": "949-361-4868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 AVENIDA PICO STE K",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926736956",
            "telephone_number": "949-361-4867",
            "fax_number": "949-361-4868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WRIGHT",
        "first_name": "RAYMOND",
        "middle_name": "LEROY",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-12",
        "last_updated": "2021-05-12",
        "certification_date": "2021-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CO",
            "license": "7983",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CA",
            "license": "63063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RAYMOND",
            "last_name": "WRIGHT, JR DDS PC",
            "middle_name": "LEROY",
            "prefix": "DR.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Kestrel Suzanne Wood Hutchison, COTA/L
• Yelena Wood, M.D.
• Mackenzie Woods
• Eric Paul Woodward
• Evita Anne Woolsey
• Rebecca Wu, M.A.
• Lauren Wynne, MA, OTR/L
• Kelly Yang, OTR/L
• Joshua Daniel Soriano Yap, NP-C
• Lisa Beth Yawn, LMFT

• Periodontics in San Clemente, CA
• Providers in San Clemente, CA by specialty
• Periodontics in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.