Richard S Gillum Inc PC

Primary specialty

DentistTaxonomy code 122300000X

License

12008573 Issued in IN

Legal business name

RICHARD S GILLUM INC PC

Practice address

1259 N State Road 135
Suite E
Greenwood, IN 46142-1033

Phone

(317) 888-7576

Fax

(317) 888-0047

NPI assigned

Jul 20, 2011

Last updated

May 17, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Shelley D Gillum

Title

Office Manager

Phone

(317) 888-7576

Specialties & licenses 2

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Richard S Gillum, D.D.S.

  • General Practice Dentistry
  • Greenwood, IN
  • NPI 1962554204
  NPD (past)

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

{
    "created_epoch": "1311120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337212800000",
    "number": "1639467913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1259 N STATE ROAD 135",
            "address_2": "SUITE E",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461421033",
            "telephone_number": "317-888-7576",
            "fax_number": "317-888-0047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1259 N STATE ROAD 135",
            "address_2": "SUITE E",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461421033",
            "telephone_number": "317-888-7576",
            "fax_number": "317-888-0047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICHARD S GILLUM INC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-20",
        "last_updated": "2012-05-17",
        "status": "A",
        "authorized_official_last_name": "GILLUM",
        "authorized_official_first_name": "SHELLEY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "317-888-7576",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "IN",
            "license": "12008573",
            "primary": true
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emma Rhodes, DC
• Brett Warren Rice
• Caleb Rice, LMFTA
• Shane Matthew Rice
• Richard & Armstrong Optometry
• Ja-Lisa Richard, RBT
• Jon Anthony Richardson
• Michael Wilson Richardson, CMT
• Raychel Richardson, RBT
• Vanessa Renee Richardson, MS, OTR

• Dentist in Greenwood, IN
• Providers in Greenwood, IN by specialty
• Dentist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2012; 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.