Individual provider Active NPI

Richard Edward Patrick, D.D.S.

  • General Practice Dentistry
  • Overland Park, KS
National Provider Identifier
1710975792
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5541 Issued in KS
Practice address
4500 College Blvd
Suite 302
Overland Park, KS 66211-1799
Phone
(913) 491-1191
Fax
(913) 491-1192
NPI assigned
Oct 12, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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 5541 KS Primary

Addresses

Primary practice location

4500 College Blvd
Suite 302
Overland Park, KS 66211-1799

Mailing address

4500 College Blvd
Suite 302
Overland Park, KS 66211-1799
Phone (913) 491-1191

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
5541KSMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Richard E Patrick DDS PA Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1129075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1710975792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 COLLEGE BLVD",
            "address_2": "SUITE 302",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662111799",
            "telephone_number": "913-491-1191",
            "fax_number": "913-491-1192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 COLLEGE BLVD",
            "address_2": "SUITE 302",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662111799",
            "telephone_number": "913-491-1191",
            "fax_number": "913-491-1192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATRICK",
        "first_name": "RICHARD",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-12",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KS",
            "license": "5541",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Overland Park, KS

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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.