Individual provider Active NPI

Angela Daun Richeson, DMD

  • Dentist
  • Moses Lake, WA
National Provider Identifier
1720210693
Registry record updated Aug 11, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DENT.DE.60092562 Issued in WA
Practice address
605 S Coolidge St
Moses Lake, WA 98837-1893
Phone
(509) 766-8977
NPI assigned
Aug 11, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DENT.DE.60092562 WA Primary

Addresses

Primary practice location

605 S Coolidge St
Moses Lake, WA 98837-1893

Mailing address

605 S Coolidge St
Moses Lake, WA 98837-1893
Phone (509) 766-8977

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20160509001242 WA Order and Referring Only - DentistPractitioner - Dentist 5496054751

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DENT.DE.60092562WAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1249948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1249948800000",
    "number": "1720210693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 S COOLIDGE ST",
            "city": "MOSES LAKE",
            "state": "WA",
            "postal_code": "988371893",
            "telephone_number": "509-766-8977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 S COOLIDGE ST",
            "city": "MOSES LAKE",
            "state": "WA",
            "postal_code": "988371893",
            "telephone_number": "509-766-8977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHESON",
        "first_name": "ANGELA",
        "middle_name": "DAUN",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-11",
        "last_updated": "2009-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DENT.DE.60092562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moses Lake, WA

Sources for this page

Verify at the official NPI Registry.