Individual provider Active NPI

John M. Richards, DDS, MS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Fort Myers, FL
National Provider Identifier
1669737086
Registry record updated Feb 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
0012392 Issued in FL
Practice address
6300 Whiskey Creek Dr
Fort Myers, FL 33919-8710
Phone
(239) 936-1808
Fax
(239) 936-1457
NPI assigned
Jul 11, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 5, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 0012392 FL Primary

Addresses

Primary practice location

6300 Whiskey Creek Dr
Fort Myers, FL 33919-8710

Mailing address

6300 Whiskey Creek Dr
Fort Myers, FL 33919-8710
Phone (239) 936-1808

Other practice location 1

14 Del Prado Blvd N Ste 202
Cape Coral, FL 33909-2797
Phone (239) 458-2002

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
0012392FLMDOrthodontics and Dentofacial Orthopedic Dentist

NPI Registry JSON

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

{
    "created_epoch": "1341964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549324800000",
    "number": "1669737086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6300 WHISKEY CREEK DR",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339198710",
            "telephone_number": "239-936-1808",
            "fax_number": "239-936-1457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6300 WHISKEY CREEK DR",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339198710",
            "telephone_number": "239-936-1808",
            "fax_number": "239-936-1457"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14 Del Prado Blvd N Ste 202",
            "address_purpose": "LOCATION",
            "city": "Cape Coral",
            "state": "FL",
            "postal_code": "339092797",
            "country_code": "US",
            "telephone_number": "239-458-2002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RICHARDS",
        "first_name": "JOHN",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "DDS, MS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-07-11",
        "last_updated": "2019-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "FL",
            "license": "0012392",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2019; 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.