Douglas La Roi Risk, DDS – General Practice Dentistry

Key facts

NPI: 1508829458
Entity type: Individual (NPI type 1)
Primary specialty: General Practice Dentistry 1223G0001X
License: 16615 (MD)
Practice address: 13350 HG Truman
Solomons, MD 20688
Phone: (410) 326-4078
NPI assigned: Apr 11, 2006
Sex: Male
Sole proprietor: No

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.

Tidewater LLC Dentist · Solomons, MD · NPI 1407369143

NPD DENTIST

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

State licenses

License	State	Type	Specialty
16615	MD	MD	Clinical Social Worker
DEN4845	DC	MD	General Practice Dentistry

Practice roles

Organization	Specialty	Status	New patients
Tidewater LLC	Dentist	Current since Sep 5, 2023	Accepting new patients

Locations

13350 Hg Trueman Rd
Solomons, MD 20688
Phone (410) 326-4078

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Dentist	122300000X	16615	MD
General Practice Dentistry	1223G0001X	DEN4845	DC
General Practice Dentistry	1223G0001X	16615	MD	Yes

Addresses

Primary practice location

13350 HG Truman
Solomons, MD 20688

Mailing address

3715 Chancellors Run PL
Nanjemoy, MD 20662-3033
Phone (240) 682-1019

Other providers in Solomons, MD

All providers in Solomons, MD · General Practice Dentistry in Maryland

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 29, 2023. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.