Richard Nelson Diaz, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2571 Issued in WV

Practice address

115 S Charles St
Charles Town, WV 25414

Phone

(304) 725-4492

Fax

(304) 725-9700

NPI assigned

Jul 26, 2006

Last updated

Jul 2, 2018By 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 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WV

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.

• Richard Diaz, DDS Inc.

  • General Practice Dentistry
  • Charles Town, WV
  • NPI 1700807856
  NPD (past) Authorized official
• U M FDSP Associates PA

  • Dentist
  • Baltimore, MD
  • NPI 1831780253
  NPD (past)

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530489600000",
    "number": "1760406706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2716 WOLFE DR",
            "city": "KNOXVILLE",
            "state": "MD",
            "postal_code": "217588802",
            "telephone_number": "301-834-8781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 S CHARLES ST",
            "city": "CHARLES TOWN",
            "state": "WV",
            "postal_code": "25414",
            "telephone_number": "304-725-4492",
            "fax_number": "304-725-9700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "650 W Baltimore St Ste 5201",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212011510",
            "country_code": "US",
            "telephone_number": "410-706-5806",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIAZ",
        "first_name": "RICHARD",
        "middle_name": "NELSON",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2018-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MD",
            "license": "84",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WV",
            "license": "2571",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0136653000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Grant Michael Davis
• Lisa Defazio
• Developmental Evolution, LLC (Mental and Social Health Center)
• Amber M Dever, SLP
• Dhurba Prasad Dhungana, MD
• Leslie Anne Dieter
• Rodrigo Dilag
• Romeo Dilag Jr.
• Alexis Danielle Dixon, MS
• Doja Logistics LLC

• General Practice Dentistry in Charles Town, WV
• Providers in Charles Town, WV by specialty
• General Practice Dentistry in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2018; 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.