Phillip Riesselman, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

100976 Issued in CO

Practice address

6262 S Parker Rd
Ste 300
Centennial, CO 80016-1257

Phone

(303) 690-4500

NPI assigned

Apr 24, 2007

Last updated

Feb 25, 2015By 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

Enrolled in CO

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

Medicare enrollment (NPD)

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.

• Heather Park Dental Care, LLC

  dba Heather Park Dental Care

  • General Practice Dentistry
  • Centennial, CO
  • NPI 1235214065
  NPD (past)

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424822400000",
    "number": "1750500427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6262 S PARKER RD",
            "address_2": "SUITE 300",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "800161257",
            "telephone_number": "303-690-4500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6262 S PARKER RD",
            "address_2": "STE 300",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "800161257",
            "telephone_number": "303-690-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIESSELMAN",
        "first_name": "PHILLIP",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-24",
        "last_updated": "2015-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "100976",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Scott Rickman, MA
• Ridetoo Inc.
• Randall Riebel
• Katharine Rienerth, LAC
• Ashley D Rieple, O.D.
• Ashleigh Rigg, PAC
• Stacy Lynnette Riley, O.D.
• Samantha Rimer
• Vandi Rimer, O.D.
• Gabriela Kathlina Rindfleisch, PA-C

• General Practice Dentistry in Centennial, CO
• Providers in Centennial, CO by specialty
• General Practice Dentistry in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2015; 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.

Verify at the official NPI Registry.