Douglas Dennis Richardson Sr., DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

14501 Issued in OH

Practice address

4100 W 3Rd St
Dental (160)
Dayton, OH 45428-9000

Phone

(937) 262-2102

Fax

(937) 267-5355

NPI assigned

Jul 28, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Dayton VA Medican Center

  • General Practice Dentistry
  • Dayton, OH
  • NPI 1669855144
  NPD (past)

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1700890340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2479 INDIAN WELLS TRL",
            "city": "XENIA",
            "state": "OH",
            "postal_code": "453859384",
            "telephone_number": "937-262-2102",
            "fax_number": "937-267-5355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 W 3RD ST",
            "address_2": "DENTAL (160)",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454289000",
            "telephone_number": "937-262-2102",
            "fax_number": "937-267-5355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARDSON",
        "first_name": "DOUGLAS",
        "middle_name": "DENNIS",
        "name_prefix": "Dr.",
        "name_suffix": "Sr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "OH",
            "license": "14501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clayton Richardson, LSW
• Cleopatra Richardson
• Cynthia Jene Richardson, HOME CARE PROVIDER
• Dana M Richardson, CRNA
• Dekoreye Richardson
• Ju'Keysha Richardson
• Kalyn Alicia Richardson, RN
• Laura Elizabeth Richardson, PHARMD
• Lynn Amy Richardson, D.O.
• Megan Ann Richardson, MS, RD, LD

• Oral and Maxillofacial Surgery (Dentist) in Dayton, OH
• Providers in Dayton, OH by specialty
• Oral and Maxillofacial Surgery (Dentist) in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.