Robert Derek Richesin, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

AL4541 Issued in AL

Practice address

3920 Grants Mill Rd
Birmingham, AL 35210-1204

Phone

(205) 956-8977

Fax

(205) 956-8340

NPI assigned

Mar 23, 2007

Last updated

Jul 8, 2007By the provider in NPPES

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

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Feb 8, 2016 through Feb 8, 2028

Medicare enrollment (NPD)

Not 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Alabama Dental Associates

  • Dentist
  • Birmingham, AL
  • NPI 1811452253
  NPD (past)

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

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1447377783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3920 GRANTS MILL RD",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352101204",
            "telephone_number": "205-956-8977",
            "fax_number": "205-956-8340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3920 GRANTS MILL RD",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352101204",
            "telephone_number": "205-956-8977",
            "fax_number": "205-956-8340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHESIN",
        "first_name": "ROBERT",
        "middle_name": "DEREK",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AL",
            "license": "AL4541",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan S Richardson, O.D.
• Tajuan Lasha Richardson, NP
• Trey Richardson, MD
• William Richardson
• Brian Michael Richerzhagen, DMD
• Jeffrey Richey
• Theresa Massey Richmond, RPH
• Holly Richter
• Robert Patrick Richter, M.D.
• Rebekah Danielle Rickels

• General Practice Dentistry in Birmingham, AL
• Providers in Birmingham, AL by specialty
• General Practice Dentistry in Alabama

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

Verify at the official NPI Registry.