Kelly Jo Riley, D.M.D.

Primary specialty

DentistTaxonomy code 122300000X

License

DE60305453 Issued in WA

Practice address

7725 NE Highway 99
Vancouver, WA 98665-8834

Phone

(360) 696-4487

NPI assigned

Aug 9, 2012

Last updated

Nov 23, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

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

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

{
    "created_epoch": "1344470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1448236800000",
    "number": "1336496264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22500NW67TH AVE",
            "city": "RIDGEFIELD",
            "state": "WA",
            "postal_code": "986428534",
            "telephone_number": "541-282-3787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7725 NE HIGHWAY 99",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986658834",
            "telephone_number": "360-696-4487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RILEY",
        "first_name": "KELLY",
        "middle_name": "JO",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-09",
        "last_updated": "2015-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE60305453",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Right Price Dental (Premier Dental)
• Constance Lovejoy Rigney, L.AC.
• Carrie Piper Riley, OTRL
• Craig A Riley, MD
• Jamila Riley
• Lauren Riley, PSY.D.
• Sylvia Gibson Riley, MD
• Lee-Ann Marie Rilling
• Katelyn D Rimer
• Tara Lynn Rinard, DPT

• Dentist in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Dentist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2015; 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.