Active NPI
Fain Richardson
- Dentist
- Pinetop, AZ
National Provider Identifier
1386045532
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 1001010-14
- Practice address
- PO Box 622
Pinetop, AZ 85935-0622 - Phone
- (970) 620-0060
- NPI assigned
- Sep 8, 2014
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 1001010-14 | WI | Primary |
Addresses
Primary practice location
PO Box 622
Pinetop, AZ 85935-0622
Mailing address
3470 County Road 13
Meeker, CO 81641-7719
Phone (970) 620-0060
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1001010-14 | WI | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1410134400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1729728000000",
"number": "1386045532",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3470 COUNTY ROAD 13",
"city": "MEEKER",
"state": "CO",
"postal_code": "816417719",
"telephone_number": "970-620-0060"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "PO BOX 622",
"city": "PINETOP",
"state": "AZ",
"postal_code": "859350622",
"telephone_number": "970-620-0060"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RICHARDSON",
"first_name": "FAIN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-09-08",
"last_updated": "2024-10-24",
"certification_date": "2024-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "WI",
"license": "1001010-14",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pinetop, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.