Individual provider Active NPI

Douglas Richard Reich, D.M.D.

  • Pediatric Dentistry
  • Philadelphia, PA
National Provider Identifier
1669402517
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
DS020700L Issued in PA
Practice address
7122 Rising Sun Ave
Philadelphia, PA 19111-3957
Phone
(215) 725-8300
Fax
(215) 725-8770
NPI assigned
Jul 4, 2006
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
Pediatric Dentistry 1223P0221X DS020700L PA Primary

Addresses

Primary practice location

7122 Rising Sun Ave
Philadelphia, PA 19111-3957

Mailing address

6 Cropwell LN
Holland, PA 18966-2583
Phone (215) 579-4751

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20160210001579 PA Order and Referring Only - DentistPractitioner - Dentist 0042514135

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1669402517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 CROPWELL LN",
            "city": "HOLLAND",
            "state": "PA",
            "postal_code": "189662583",
            "telephone_number": "215-579-4751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7122 RISING SUN AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191113957",
            "telephone_number": "215-725-8300",
            "fax_number": "215-725-8770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REICH",
        "first_name": "DOUGLAS",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "PA",
            "license": "DS020700L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.