Individual provider Active NPI

Ryan Richards, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Long Branch, NJ
National Provider Identifier
1801139035
Registry record updated Apr 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
22DI02574800 Issued in NJ
Practice address
300 2ND Ave
Long Branch, NJ 07740-6303
Phone
(732) 222-5200
NPI assigned
Apr 6, 2013
Last updated
Apr 13, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2019

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 22DI02574800 NJ Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

300 2ND Ave
Long Branch, NJ 07740-6303

Mailing address

170 Prospect Ave Apt 15T
Hackensack, NJ 07601-1864

Other practice location 1

5901 E 7th St
Long Beach, CA 90822-5201
Phone (562) 826-8000

Other practice location 2

1540 Rte 46
Little Falls, NJ 07424
Phone (973) 812-6550

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20180814000289 NJ Order and Referring Only - DentistPractitioner - Dentist 5799034492

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22DI02574800NJMDOral and Maxillofacial Surgery (Dentist)

NPI Registry JSON

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

{
    "created_epoch": "1365206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555113600000",
    "number": "1801139035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 PROSPECT AVE APT 15T",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076011864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 2ND AVE",
            "city": "LONG BRANCH",
            "state": "NJ",
            "postal_code": "077406303",
            "telephone_number": "732-222-5200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5901 E 7th St",
            "address_purpose": "LOCATION",
            "city": "Long Beach",
            "state": "CA",
            "postal_code": "908225201",
            "country_code": "US",
            "telephone_number": "562-826-8000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1540 Rte 46",
            "address_purpose": "LOCATION",
            "city": "Little Falls",
            "state": "NJ",
            "postal_code": "07424",
            "country_code": "US",
            "telephone_number": "973-812-6550",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RICHARDS",
        "first_name": "RYAN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-06",
        "last_updated": "2019-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NJ",
            "license": "22DI02574800",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Branch, NJ

Sources for this page

Verify at the official NPI Registry.