Samrah Riaz

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6001852-15 Issued in WI

Practice address

2719 Calumet Ave
Manitowoc, WI 54220-5546

Phone

(920) 686-2333

NPI assigned

Dec 25, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

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

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

{
    "created_epoch": "1735084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752624000000",
    "number": "1790593580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 BURR OAK CT",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531898400",
            "telephone_number": "262-744-5838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2719 CALUMET AVE",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542205546",
            "telephone_number": "920-686-2333"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3450 Lacey Rd",
            "address_purpose": "LOCATION",
            "city": "Downers Grove",
            "state": "IL",
            "postal_code": "605155430",
            "country_code": "US",
            "telephone_number": "630-743-4500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RIAZ",
        "first_name": "SAMRAH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-25",
        "last_updated": "2025-07-16",
        "certification_date": "2025-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "WI",
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "6001852-15",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ann M Rens, RN, BSN
• Michael J Retzinger, M.S., CCC-SLP
• Sarah Reveal, APNP
• Brittany E Rezek, PTA
• Richard J Rhode, PHARM D
• Kora Ribley, PTA
• Rebecca A Richards, LPC
• Dustin Jon Richter, MD
• Ann Elizabeth Riddle, RN
• Chelsea A Riddle, RN

• General Practice Dentistry in Manitowoc, WI
• Providers in Manitowoc, WI by specialty
• General Practice Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2025; 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.