Harry Mark Richter, DDS MAGD
Individual provider Active NPI Dentist · Edwards, CA
NPI 1679545305 · NPPES record last updated Nov 7, 2013
Key facts
- NPI
- 1679545305
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- DN9303 (FL)
- Practice address
- BLDG 5513
412TH Medical Group - Edwards Air Force Base
Edwards, CA 93524-0001 - Phone
- (661) 277-2972
- NPI assigned
- Feb 6, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN9303 | FL | MD | Dentist |
| DS022268L | PA | MD | Dentist |
| 401005761 | VA | MD | Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DN9303 | FL | Yes |
| Dentist | 122300000X | DS022268L | PA | |
| Dentist | 122300000X | 401005761 | VA |
Addresses
Primary practice location
BLDG 5513
412TH Medical Group - Edwards Air Force Base
Edwards, CA 93524-0001
Mailing address
BLDG 5513
412TH Medical Group - Edwards Air Force Base
Edwards, CA 93524-0001
Phone (661) 277-2972
Other providers in Edwards, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 7, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.