Richard Marvin Lipscomb, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

11783 Issued in MD

Practice address

11721 Woodmore Rd
Suite 150
Mitchellville, MD 20721-4117

Phone

(301) 430-0934

Fax

(301) 430-0936

NPI assigned

Mar 27, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Practice roles

Locations

Networks

• HealthSun Health Plans Network

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.

• Community Health of South Florida Inc

  • Federally Qualified Health Center (FQHC)
  • Miami, FL
  • NPI 1336152347
  Medicare reassignment NPD
• Community Health of South Florida, Inc

  • Federally Qualified Health Center (FQHC)
  • Key Largo, FL
  • NPI 1417704198
  NPD
• Community Health of South Florida, Inc

  • Federally Qualified Health Center (FQHC)
  • Tavernier, FL
  • NPI 1801219258
  NPD

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619095452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11721 WOODMORE RD",
            "address_2": "SUITE 150",
            "city": "MITCHELLVILLE",
            "state": "MD",
            "postal_code": "207214117",
            "telephone_number": "301-430-0934",
            "fax_number": "301-430-0936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11721 WOODMORE RD",
            "address_2": "SUITE 150",
            "city": "MITCHELLVILLE",
            "state": "MD",
            "postal_code": "207214117",
            "telephone_number": "301-430-0934",
            "fax_number": "301-430-0936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIPSCOMB",
        "first_name": "RICHARD",
        "middle_name": "MARVIN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "11783",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Krysiak
• Lake Arbor Dental Associates
• Surya Lama
• Ryun Jong Lee, D.O.
• Lifetime Dental Care of Maryland, Badger, P.C.
• Anastasia Liu, DPT
• Brittney Mabry, BCBA
• Rodney Mackey Jr.
• Magnolia Dental, LLC
• Asek Nelson Makia, M.D.

• General Practice Dentistry in Mitchellville, MD
• Providers in Mitchellville, MD by specialty
• General Practice Dentistry in Maryland

• 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.
• 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.