Active NPI
Richard Uytri Ly, D.D.S.
- Dentist
- Washington, DC
National Provider Identifier
1710962964
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DS035618
- Practice address
- 5802 Army Pentagon
Washington, DC 20307-5400 - Phone
- (703) 692-8751
- Fax
- (703) 692-6123
- NPI assigned
- Dec 9, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DS035618 | PA | Primary |
Addresses
Primary practice location
5802 Army Pentagon
Washington, DC 20307-5400
Mailing address
6900 Georgia Ave. NW
Building T20, Room 206a
Washington, DC 20307-5400
Phone (202) 782-0988
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20151229001759 | NY | Order and Referring Only - Dentist | 9133420615 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DS035618 | PA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1134086400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1710962964",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6900 GEORGIA AVE. NW",
"address_2": "BUILDING T20, ROOM 206A",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "203075400",
"telephone_number": "202-782-0988",
"fax_number": "202-782-9195"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5802 ARMY PENTAGON",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "203075400",
"telephone_number": "703-692-8751",
"fax_number": "703-692-6123"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LY",
"first_name": "RICHARD",
"middle_name": "UYTRI",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-09",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "PA",
"license": "DS035618",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Washington, DC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.