Individual provider Active NPI

Erwin M Ricafort, DENTIST

  • General Practice Dentistry
  • Murfreesboro, TN
National Provider Identifier
1629117338
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DS7663 Issued in TN
Practice address
1826 Ward Dr
Suite 204
Murfreesboro, TN 37129-0578
Phone
(615) 890-0474
Fax
(615) 890-0256
NPI assigned
Feb 6, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DS7663 TN Primary

Addresses

Primary practice location

1826 Ward Dr
Suite 204
Murfreesboro, TN 37129-0578

Mailing address

1826 Ward Dr
Suite 204
Murfreesboro, TN 37129-0578
Phone (615) 890-0474

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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

Enrollment IDStateProvider typePAC IDDetails
I20160622000314 TN Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 7214228261

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DS7663TNMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629117338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1826 WARD DR",
            "address_2": "SUITE 204",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371290578",
            "telephone_number": "615-890-0474",
            "fax_number": "615-890-0256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1826 WARD DR",
            "address_2": "SUITE 204",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371290578",
            "telephone_number": "615-890-0474",
            "fax_number": "615-890-0256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICAFORT",
        "first_name": "ERWIN",
        "middle_name": "M",
        "credential": "DENTIST",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "DS7663",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Murfreesboro, TN

Sources for this page

Verify at the official NPI Registry.