Active NPI
Richard Lee Weber Jr., D.M.D.
- Public Health Dentistry
- Clayton, GA
National Provider Identifier
1366435117
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Public Health Dentistry
- License
- DN009212
- Practice address
- 19 Jo Dotson Cir
Clayton, GA 30525-5007 - Phone
- (706) 212-0294
- NPI assigned
- Aug 26, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Public Health Dentistry | 1223D0001X | DN009212 | GA | Primary |
Addresses
Primary practice location
19 Jo Dotson Cir
Clayton, GA 30525-5007
Mailing address
204 Longview Ave
Gainesville, GA 30501-2223
Phone (770) 297-0894
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN009212 | GA | MD | Public Health Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1125014400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1185840000000",
"number": "1366435117",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "204 LONGVIEW AVE",
"city": "GAINESVILLE",
"state": "GA",
"postal_code": "305012223",
"telephone_number": "770-297-0894"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19 JO DOTSON CIR",
"city": "CLAYTON",
"state": "GA",
"postal_code": "305255007",
"telephone_number": "706-212-0294"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEBER",
"first_name": "RICHARD",
"middle_name": "LEE",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "D.M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-08-26",
"last_updated": "2007-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "1223D0001X",
"taxonomy_group": "",
"desc": "Dentist, Dental Public Health",
"state": "GA",
"license": "DN009212",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clayton, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.