Active NPI
Richard Bryan Shipp
- Dentist
- Carmichael, CA
National Provider Identifier
1386807378
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 34214
- Practice address
- 5805 Marconi Ave
Carmichael, CA 95608-4415 - Phone
- (916) 488-3943
- NPI assigned
- Jul 9, 2008
- 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 | 34214 | CA | Primary |
Addresses
Primary practice location
5805 Marconi Ave
Carmichael, CA 95608-4415
Mailing address
5805 Marconi Ave
Carmichael, CA 95608-4415
Phone (916) 488-3943
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 |
|---|---|---|---|
| 34214 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1215561600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1215561600000",
"number": "1386807378",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5805 MARCONI AVE",
"city": "CARMICHAEL",
"state": "CA",
"postal_code": "956084415",
"telephone_number": "916-488-3943"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5805 MARCONI AVE",
"city": "CARMICHAEL",
"state": "CA",
"postal_code": "956084415",
"telephone_number": "916-488-3943"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHIPP",
"first_name": "RICHARD",
"middle_name": "BRYAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-07-09",
"last_updated": "2008-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "34214",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Carmichael, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.