Individual provider Active NPI

Rickford C Redmond, DDS

  • Dentist
  • Austin, TX
National Provider Identifier
1669715124
Registry record updated Apr 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
11527 Issued in TX
Practice address
13492 Research Blvd
Suite 120-236
Austin, TX 78750-2252
Phone
(512) 422-8866
NPI assigned
Apr 3, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 3, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 11527 TX Primary

Addresses

Primary practice location

13492 Research Blvd
Suite 120-236
Austin, TX 78750-2252

Mailing address

13492 Research Blvd
Suite 120-236
Austin, TX 78750
Phone (512) 422-8866

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20160722001844 TX Order and Referring Only - DentistPractitioner - Dentist 0244523686

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11527TXMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1364947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364947200000",
    "number": "1669715124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13492 RESEARCH BLVD",
            "address_2": "SUITE 120-236",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "78750",
            "telephone_number": "512-422-8866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13492 RESEARCH BLVD",
            "address_2": "SUITE 120-236",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787502252",
            "telephone_number": "512-422-8866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDMOND",
        "first_name": "RICKFORD",
        "middle_name": "C",
        "name_prefix": "Mr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-04-03",
        "last_updated": "2013-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "11527",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.