NPIMap

Organization Active NPI

Reebye Park & Richman DDS PLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Mebane, NC
National Provider Identifier
1508158940
Registry record updated Oct 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
7381 Issued in NC
Legal business name
REEBYE PARK & RICHMAN DDS PLC
Practice address
1107 S Fifth St
Suite 250
Mebane, NC 27302-9597
Phone
(919) 237-9400
NPI assigned
May 4, 2011
Organization subpart
Yes
Parent organization
REEBYE PARK & RICHMAN DDS PLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 12, 2023

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

Authorized official

Name
Andres F Henao
Title
Technical Director
Phone
(919) 563-2897

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X
Oral and Maxillofacial Surgery (Dentist)Group: 193200000X MULTI-SPECIALTY GROUP 1223S0112X 7381 NC Primary
Oral Medicine DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 125Q00000X

Addresses

Primary practice location

1107 S Fifth St
Suite 250
Mebane, NC 27302-9597

Mailing address

1107 S Fifth St Ste 250
Mebane, NC 27302-9896
Phone (919) 563-2897

Other identifiers 1

IdentifierTypeStateIssuer
5917450MedicaidNC

Other names 1

  • Triangle Implant Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Reebye Park Richman DDS PLC6 organizations share this tax ID, including this one
Part of
Reebye Park Richman DDS PLC

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1304467200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697068800000",
    "number": "1508158940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1107 S FIFTH ST STE 250",
            "city": "MEBANE",
            "state": "NC",
            "postal_code": "273029896",
            "telephone_number": "919-563-2897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1107 S FIFTH ST",
            "address_2": "SUITE 250",
            "city": "MEBANE",
            "state": "NC",
            "postal_code": "273029597",
            "telephone_number": "919-237-9400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REEBYE PARK & RICHMAN DDS PLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "REEBYE PARK & RICHMAN DDS PLC",
        "enumeration_date": "2011-05-04",
        "last_updated": "2023-10-12",
        "certification_date": "2023-10-12",
        "status": "A",
        "authorized_official_last_name": "HENAO",
        "authorized_official_first_name": "ANDRES",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "TECHNICAL DIRECTOR",
        "authorized_official_telephone_number": "919-563-2897"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NC",
            "license": "7381",
            "primary": true
        },
        {
            "code": "125Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5917450",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Triangle Implant Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mebane, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2023; 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.