Michael Brent Riley Jr., DMD

Primary specialty

DentistTaxonomy code 122300000X

License

0401413862 Issued in VA

Practice address

3709 Old Forest Rd
Lynchburg, VA 24501-6902

Phone

(434) 385-7707

Fax

(434) 385-0738

NPI assigned

Sep 2, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

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.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1251849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621468800000",
    "number": "1518190800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3709 OLD FOREST RD",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245016902",
            "telephone_number": "434-665-1430",
            "fax_number": "434-385-0738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3709 OLD FOREST RD",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245016902",
            "telephone_number": "434-385-7707",
            "fax_number": "434-385-0738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RILEY",
        "first_name": "MICHAEL",
        "middle_name": "BRENT",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-09-02",
        "last_updated": "2021-05-20",
        "certification_date": "2021-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GA",
            "license": "DN013968",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401413862",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Riley Dental Associates
• Riley Dental Associates of Central Virginia
• Denise Stratton Riley
• Jeffrey Riley, D.D.S.
• Matthew David Riley, MD
• Angela Ripley, DPT
• Jessica Elaine Riquelme
• Emma Claire Rivas
• Kelly Marie Rivera Lewis, LMFT
• Rivermont Chiropractic, Inc.

• Dentist in Lynchburg, VA
• Providers in Lynchburg, VA by specialty
• Dentist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.