Individual provider Active NPI

Richard S Singer, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Conyers, GA
National Provider Identifier
1750499414
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
DN009698 Issued in GA
Practice address
1463 Klondike Rd
Suite C
Conyers, GA 30094
Phone
(770) 483-9692
Fax
(678) 487-1004
NPI assigned
Aug 25, 2006
Sex
Male
Sole proprietor
No

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X DN009698 GA Primary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 5001493015 WI

Addresses

Primary practice location

1463 Klondike Rd
Suite C
Conyers, GA 30094

Mailing address

1463 Klondike Road
Suite C
Conyers, GA 30094
Phone (770) 483-9692

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20110203000174 GA Practitioner - Oral Surgery 9537206602 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN009698GAMDOral and Maxillofacial Surgery (Dentist)
5001493015WIMDOral and Maxillofacial Surgery (Dentist)
9698GAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sentry Anesthesia Management, LLC PastSince Aug 17, 2022 Accepting new patients

Organizations & group practices 2

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": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1750499414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1463 KLONDIKE ROAD",
            "address_2": "SUITE C",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "30094",
            "telephone_number": "770-483-9692",
            "fax_number": "678-487-1004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1463 KLONDIKE RD",
            "address_2": "SUITE C",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "30094",
            "telephone_number": "770-483-9692",
            "fax_number": "678-487-1004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SINGER",
        "first_name": "RICHARD",
        "middle_name": "S",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "GA",
            "license": "DN009698",
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "WI",
            "license": "5001493015",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conyers, GA

Sources for this page

Verify at the official NPI Registry.