NPIMap

Individual provider Active NPI

Patricia Hanlon Rist, D.M.D.

  • Pediatric Dentistry
  • Wilmington, DE
National Provider Identifier
1619288461
Registry record updated Nov 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
G1-0001381 Issued in DE
Practice address
4201 Miller Rd
Wilmington, DE 19802-1914
Phone
(302) 765-3373
NPI assigned
Jun 27, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X DS038600 PA
Pediatric Dentistry 1223P0221X G1-0001381 DE Primary

Addresses

Primary practice location

4201 Miller Rd
Wilmington, DE 19802-1914

Mailing address

4201 Miller Rd
Wilmington, DE 19802-1914
Phone (302) 765-3373

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

LicenseStateTypeSpecialty
G1-0001381DEMDPediatric Dentist
DS038600PAMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Chesheim Dental Associates 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1277596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700438400000",
    "number": "1619288461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4201 MILLER RD",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198021914",
            "telephone_number": "302-765-3373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 MILLER RD",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198021914",
            "telephone_number": "302-765-3373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIST",
        "first_name": "PATRICIA",
        "middle_name": "HANLON",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-27",
        "last_updated": "2023-11-20",
        "certification_date": "2023-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "PA",
            "license": "DS038600",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "DE",
            "license": "G1-0001381",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 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.