Active NPI
Don Calvin Riley Jr., DMD
- General Practice Dentistry
- No Myrtle Beach, SC
National Provider Identifier
1437281250
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 2681
- Practice address
- 602 17TH Ave So
No Myrtle Beach, SC 29582 - Phone
- (843) 272-1121
- Fax
- (843) 272-9976
- NPI assigned
- Mar 9, 2007
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 2681 | SC | Primary |
Addresses
Primary practice location
602 17TH Ave So
No Myrtle Beach, SC 29582
Mailing address
602 17TH Ave So
No Myrtle Beach, SC 29582
Phone (843) 272-1121
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ZZ2681 | Medicaid | SC |
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 |
|---|---|---|---|
| 2681 | SC | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| D. Calvin Riley Jr. DMD PA | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173398400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1437281250",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "602 17TH AVE SO",
"city": "NO MYRTLE BEACH",
"state": "SC",
"postal_code": "29582",
"telephone_number": "843-272-1121",
"fax_number": "843-272-9976"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "602 17TH AVE SO",
"city": "NO MYRTLE BEACH",
"state": "SC",
"postal_code": "29582",
"telephone_number": "843-272-1121",
"fax_number": "843-272-9976"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RILEY",
"first_name": "DON",
"middle_name": "CALVIN",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-09",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "SC",
"license": "2681",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "ZZ2681",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}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.