Katie Lauren Riesenberg, D.M.D.

Primary specialty

DentistTaxonomy code 122300000X

License

9281 Issued in SC

Practice address

3074 Deville St
Myrtle Beach, SC 29577

Phone

(843) 839-4554

NPI assigned

Jun 20, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Riesenberg Family Dental, LLC

  • Dental Clinic/Center
  • North Myrtle Beach, SC
  • NPI 1558052514
  NPD Authorized official
• Happy Teeth Happy Kids, LLC

  • General Practice Dentistry
  • Myrtle Beach, SC
  • NPI 1225410558
  NPD (past)
• Fresh Dental

  • Dental Clinic/Center
  • Cincinnati, OH
  • NPI 1265039465
  NPD (past)

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

{
    "created_epoch": "1466380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548892800000",
    "number": "1356791446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3074 DEVILLE ST",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295771569",
            "telephone_number": "513-484-4740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3074 DEVILLE ST",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "29577",
            "telephone_number": "843-839-4554"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11907 Montgomery Rd",
            "address_purpose": "LOCATION",
            "city": "Cincinnati",
            "state": "OH",
            "postal_code": "452491726",
            "country_code": "US",
            "telephone_number": "513-697-1211",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3074 DeVille St",
            "address_purpose": "LOCATION",
            "city": "Myrtle Beach",
            "state": "SC",
            "postal_code": "29577",
            "country_code": "US",
            "telephone_number": "843-839-4554",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RIESENBERG",
        "first_name": "KATIE",
        "middle_name": "LAUREN",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-20",
        "last_updated": "2019-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30.024988",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "SC",
            "license": "9281",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• April Rich, RN
• David D Rich, M.D.
• Zakary Rich
• Tracy C Richardson, FNP
• Katina Richmond, PHARMD
• Misty R Riggan
• Meg Mackenzie Riley, DO
• Shawn F Riley, MD
• Emily Rinehart
• Christina Marie Ring, PTA

• Dentist in Myrtle Beach, SC
• Providers in Myrtle Beach, SC by specialty
• Dentist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.