Active NPI
Bevan Milton Richardson, D.D.S.
- Dentist
- Rio Linda, CA
National Provider Identifier
1568599348
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 23948
- Practice address
- 851 Oak LN
Rio Linda, CA 95673-2341 - Phone
- (916) 991-6402
- Fax
- (916) 991-7297
- NPI assigned
- Feb 27, 2007
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 23948 | CA | Primary |
Addresses
Primary practice location
851 Oak LN
Rio Linda, CA 95673-2341
Mailing address
851 Oak LN
Rio Linda, CA 95673-2341
Phone (916) 991-6402
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
| License | State | Type | Specialty |
|---|---|---|---|
| 23948 | CA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bevan Richardson | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Dental Clinic/Center
- Rio Linda, CA
- NPI 1770085375
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172534400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1568599348",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "851 OAK LN",
"city": "RIO LINDA",
"state": "CA",
"postal_code": "956732341",
"telephone_number": "916-991-6402",
"fax_number": "916-991-7297"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "851 OAK LN",
"city": "RIO LINDA",
"state": "CA",
"postal_code": "956732341",
"telephone_number": "916-991-6402",
"fax_number": "916-991-7297"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RICHARDSON",
"first_name": "BEVAN",
"middle_name": "MILTON",
"name_prefix": "Prof.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "23948",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rio Linda, CA
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.