Richard Fiese Oral & Maxillofacial Surgeon PC

Primary specialty

DentistTaxonomy code 122300000X

License

0407871 Issued in NY

Legal business name

RICHARD FIESE ORAL & MAXILLOFACIAL SURGEON PC

Practice address

105 Co RT 45a
Suite 100
Oswego, NY 13126

Phone

(315) 343-6160

Fax

(315) 343-8556

NPI assigned

Aug 14, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Richard L Fiese, DMD

Title

President

Phone

(315) 343-6160

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Dr D Langlois & Dr R Fiese Oral & Maxillofacial Surgeons PC Former legal business name

Locations

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1801809793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 CO RT 45A",
            "address_2": "SUITE 100",
            "city": "OSWEGO",
            "state": "NY",
            "postal_code": "13126",
            "telephone_number": "315-343-6160",
            "fax_number": "315-343-8556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 CO RT 45A",
            "address_2": "SUITE 100",
            "city": "OSWEGO",
            "state": "NY",
            "postal_code": "13126",
            "telephone_number": "315-343-6160",
            "fax_number": "315-343-8556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICHARD FIESE ORAL & MAXILLOFACIAL SURGEON PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FIESE",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "315-343-6160",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "NY",
            "license": "0407871",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01046088",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dr D Langlois & Dr R Fiese Oral & Maxillofacial Surgeons PC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Lakeisha Rhyant, M.S
• Brenda Jean Rice, RN
• Heather L Rice, LMHC
• Jillian Rice
• Makaela Rice
• Brian Jon Richardson, RPH
• Pepper L Richardson, LPN
• Roxanne Hall Richardson, RPH
• Nancy Richman
• June M Rickli, MS

• Dentist in Oswego, NY
• Providers in Oswego, NY by specialty
• Dentist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.