Individual provider Active NPI

Richard Edward Heyes Jr., D.D.S.

  • General Practice Dentistry
  • Glendale, CA
National Provider Identifier
1700880614
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
28002 Issued in CA
Practice address
428 Arden Ave
Ste 200
Glendale, CA 91203-4012
Phone
(818) 241-8131
Fax
(818) 243-9972
NPI assigned
Jun 8, 2005
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
General Practice Dentistry 1223G0001X 28002 CA Primary

Addresses

Primary practice location

428 Arden Ave
Ste 200
Glendale, CA 91203-4012

Mailing address

428 Arden Ave
Ste 200
Glendale, CA 91203-4012
Phone (818) 241-8131

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20161118002304 CA Order and Referring Only - DentistPractitioner - Dentist 4082993704

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
28002CAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1118188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1700880614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "428 ARDEN AVE",
            "address_2": "STE 200",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912034012",
            "telephone_number": "818-241-8131",
            "fax_number": "818-243-9972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "428 ARDEN AVE",
            "address_2": "STE 200",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912034012",
            "telephone_number": "818-241-8131",
            "fax_number": "818-243-9972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEYES",
        "first_name": "RICHARD",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "28002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

Verify at the official NPI Registry.