Individual provider Active NPI

Richard James Richardson II, M.S., D.D.S.

  • Pediatric Dentistry
  • Corona, CA
National Provider Identifier
1407944937
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
37277 Issued in CA
Practice address
910 Washburn Ave
Suite B
Corona, CA 92882-4383
Phone
(951) 735-2011
Fax
(951) 735-6322
NPI assigned
Oct 10, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 37277 CA Primary

Addresses

Primary practice location

910 Washburn Ave
Suite B
Corona, CA 92882-4383

Mailing address

910 Washburn Ave
Suite B
Corona, CA 92882-4383
Phone (951) 735-2011

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
37277CAMDPediatric Dentist

NPI Registry JSON

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407944937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "910 WASHBURN AVE",
            "address_2": "SUITE B",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928824383",
            "telephone_number": "951-735-2011",
            "fax_number": "951-735-6322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 WASHBURN AVE",
            "address_2": "SUITE B",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928824383",
            "telephone_number": "951-735-2011",
            "fax_number": "951-735-6322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARDSON",
        "first_name": "RICHARD",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "M.S., D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "37277",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corona, CA

Sources for this page

  • 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.