Individual provider Active NPI

Eric R Rieger, DDS

  • General Practice Dentistry
  • Hollywood, FL
National Provider Identifier
1790985067
Registry record updated Jul 24, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN0012394 Issued in FL
Practice address
4420 Sheridan St
Apt. B
Hollywood, FL 33021-3552
Phone
(954) 966-6352
NPI assigned
Jul 24, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN0012394 FL Primary

Addresses

Primary practice location

4420 Sheridan St
Apt. B
Hollywood, FL 33021-3552

Mailing address

4420 Sheridan St
Apt. B
Hollywood, FL 33021-3552
Phone (954) 966-6352

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20160204001241 FL Order and Referring Only - DentistPractitioner - Dentist 2567766934

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN0012394FLMDGeneral Practice Dentistry

Networks

  • Freedom Health HMO Network

NPI Registry JSON

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

{
    "created_epoch": "1185235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1185235200000",
    "number": "1790985067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4420 SHERIDAN ST",
            "address_2": "APT. B",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330213552",
            "telephone_number": "954-966-6352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4420 SHERIDAN ST",
            "address_2": "APT. B",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330213552",
            "telephone_number": "954-966-6352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIEGER",
        "first_name": "ERIC",
        "middle_name": "R",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-24",
        "last_updated": "2007-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN0012394",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

Verify at the official NPI Registry.