Individual provider Active NPI

Andrew Raymond Rieser, DMD

  • General Practice Dentistry
  • Washington, MO
National Provider Identifier
1457449092
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2003015190 Issued in MO
Practice address
1351 Jefferson St
Suite 308
Washington, MO 63090-6449
Phone
(636) 239-7654
Fax
(636) 239-5598
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
General Practice Dentistry 1223G0001X 2003015190 MO Primary

Addresses

Primary practice location

1351 Jefferson St
Suite 308
Washington, MO 63090-6449

Mailing address

4756 Auburn Trace Dr
Saint Louis, MO 63128-2851
Phone (314) 200-8216

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

LicenseStateTypeSpecialty
2003015190MOMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Rieser Family Dental, L.L.C. General Practice 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": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1457449092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4756 AUBURN TRACE DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282851",
            "telephone_number": "314-200-8216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1351 JEFFERSON ST",
            "address_2": "SUITE 308",
            "city": "WASHINGTON",
            "state": "MO",
            "postal_code": "630906449",
            "telephone_number": "636-239-7654",
            "fax_number": "636-239-5598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIESER",
        "first_name": "ANDREW",
        "middle_name": "RAYMOND",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "2003015190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, MO

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.