Annette I Riley X, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

3757 Issued in SC

Practice address

421 Bush River Rd
Columbia, SC 29210-7332

Phone

(803) 798-6333

Fax

(803) 798-0701

NPI assigned

Jul 30, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Columbia Dentistry, LLC

  • Dentist
  • Columbia, SC
  • NPI 1699040246
  NPD (past)

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649285487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "421 BUSH RIVER RD",
            "address_2": "DUTCH SQUARE CENTER #5",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292107332",
            "telephone_number": "803-798-6333",
            "fax_number": "803-798-0701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "421 BUSH RIVER RD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292107332",
            "telephone_number": "803-798-6333",
            "fax_number": "803-798-0701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RILEY",
        "first_name": "ANNETTE",
        "middle_name": "I",
        "name_prefix": "Dr.",
        "name_suffix": "X",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "3757",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZA9559",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "3757",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristen Riglietti, LPC
• Mark Rigsby, MLS (ASCP)CM
• Rosemary Riles, RD
• Riley Orthopedic and Medical Massage, LLC
• Veola Rasheena Riley-Amaker, APRN
• Ashlynn Riley
• Deidra Nicole Riley
• Francimer Riley
• Howard Avery Riley, RRT
• Isabelle Marie Riley, MD

• General Practice Dentistry in Columbia, SC
• Providers in Columbia, SC by specialty
• General Practice Dentistry in South Carolina

• 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.

Verify at the official NPI Registry.