Richard William Reddy, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS-019558-L Issued in PA

Practice address

805 N Richmond St
Suite 102
Fleetwood, PA 19522-1031

Phone

(610) 944-9771

Fax

(610) 944-0702

NPI assigned

Jun 27, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Fleetwood Dental Professional Corporation

  • General Practice Dentistry
  • Fleetwood, PA
  • NPI 1104091388
  NPD (past)

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407883242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "414 GROVE RD",
            "city": "MOHRSVILLE",
            "state": "PA",
            "postal_code": "195418872",
            "telephone_number": "610-926-3600",
            "fax_number": "610-926-5500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 N RICHMOND ST",
            "address_2": "SUITE 102",
            "city": "FLEETWOOD",
            "state": "PA",
            "postal_code": "195221031",
            "telephone_number": "610-944-9771",
            "fax_number": "610-944-0702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDDY",
        "first_name": "RICHARD",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS-019558-L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Victoria Frances Psomiadis, M.D.
• Kristin Ransom, MT-BC
• Crystal Rauenzahn, ED.D, BSL
• Tiffanie Elise Ream, PTA
• David Rechlicz
• Eleanor Reiter, LPC, NCC, CCTP, CFTP
• Jocelyne Resendiz, LBS
• Morgan Shade Richards, DPT
• Michael Rodriguez
• Michelle Rohrbach

• General Practice Dentistry in Fleetwood, PA
• Providers in Fleetwood, PA by specialty
• General Practice Dentistry in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.