Individual provider Active NPI

Richard Steven Phillips, DDS

  • Dentist
  • San Clemente, CA
National Provider Identifier
1467606665
Registry record updated Nov 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
27819 Issued in CA
Practice address
224 W Avenida Valencia
San Clemente, CA 92672-4242
Phone
(949) 412-5392
Fax
(949) 498-4446
NPI assigned
Nov 14, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 14, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 27819 CA Primary

Addresses

Primary practice location

224 W Avenida Valencia
San Clemente, CA 92672-4242

Mailing address

PO Box 74324
San Clemente, CA 92673-0145
Phone (949) 412-5392

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

NPI Registry JSON

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

{
    "created_epoch": "1226620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1226620800000",
    "number": "1467606665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 74324",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926730145",
            "telephone_number": "949-412-5392",
            "fax_number": "949-498-4446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "224 W AVENIDA VALENCIA",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926724242",
            "telephone_number": "949-412-5392",
            "fax_number": "949-498-4446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "RICHARD",
        "middle_name": "STEVEN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-11-14",
        "last_updated": "2008-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "27819",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Clemente, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2008; 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.