Riata Valley Dental Group

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

RIATA VALLEY DENTAL GROUP

Practice address

1111 Riata Valley Rd Ste 350
Kingman, AZ 86409-3719

Phone

(928) 757-9190

NPI assigned

Oct 29, 2018

Organization subpart

No

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

Authorized official

Name

Leighann Samson

Title

Manager

Phone

(928) 753-5069

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• David Scott Charon, D.M.D.

  • General Practice Dentistry
  • Kingman, AZ
  • NPI 1841677713
  NPD (past)
• Regina Elizabeth Cobb, DDS

  • Dentist
  • Kingman, AZ
  • NPI 1689888000
  NPD (past)

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

{
    "created_epoch": "1540771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540771200000",
    "number": "1669949582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1720 E BEVERLY AVE",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864093567",
            "telephone_number": "928-753-5069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 RIATA VALLEY RD STE 350",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864093719",
            "telephone_number": "928-757-9190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIATA VALLEY DENTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-29",
        "last_updated": "2018-10-29",
        "status": "A",
        "authorized_official_last_name": "SAMSON",
        "authorized_official_first_name": "LEIGHANN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "928-753-5069"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rescare Arizona, Inc.
• Danielle Resendez, FNP-C
• Ruben Dario Restrepo
• Damon Andrew Reynolds, M.D.
• Gabrielle Reynolds
• Brittney Rice, MSN, PMHNP-BC
• Brett Riche, D.M.D.
• Danelle Ritch, FNP-C
• Michael Ritch, FNP-C
• Edgardo Rivera, M. D.

• General Practice Dentistry in Kingman, AZ
• Providers in Kingman, AZ by specialty
• General Practice Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2018; 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.