Richard Hugh Ward, D.D.S.
Individual provider Active NPI Dentist · Teecnospos, AZ
NPI 1356582480 · NPPES record last updated Sep 8, 2011
Key facts
- NPI
- 1356582480
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 25305 (CA)
- Practice address
- US Hwy 160 and Navajo RT. 135
Red Mesa
Teecnospos, AZ 86514 - Phone
- (928) 656-5216
- Fax
- (928) 656-5201
- NPI assigned
- Mar 19, 2009
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25305 | CA | MD | Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 25305 | CA | Yes |
Addresses
Primary practice location
US Hwy 160 and Navajo RT. 135
Red Mesa
Teecnospos, AZ 86514
Mailing address
US Hwy 160 and Navajo RT. 135
Red Mesa
Teecnospos, AZ 86514
Phone (928) 656-5216
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 25305 | Other | CA | DENTAL LICENSE |
Other providers in Teecnospos, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 8, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.