John James Richter III, D.D.S.
Individual provider Active NPI Public Health Dentistry · Isleta, NM
NPI 1831169986 · NPPES record last updated Jul 13, 2026
Key facts
- NPI
- 1831169986
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Public Health Dentistry 1223D0001X
- License
- DD1961 (NM)
- Practice address
- 1 Sagebrush St
Isleta, NM 87022 - Phone
- (505) 869-4499
- NPI assigned
- Jan 23, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160219001479 | TX | Order and Referring Only - Dentist |
4385949932 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DD1961 | NM | MD | Public Health Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Public Health Dentistry | 1223D0001X | DD1961 | NM | Yes |
Addresses
Primary practice location
1 Sagebrush St
Isleta, NM 87022
Mailing address
1800 Valdez Dr NE
Albuquerque, NM 87112-4827
Phone (505) 291-9605
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 59970227 | Medicaid | NM |
Other providers in Isleta, NM
- Pueblo of Isleta
- Pueblo of Isleta
- Pueblo of Isleta Assisted Living Facility
- Pueblo of Isleta Behavioral Health
- Gabriel I Rael
- Karen Marie Roop
- Jennifer Sandoval
- Juanita Sena
- Brandy L. Shinnick
- Veronica Sprunk
All providers in Isleta, NM · Public Health Dentistry in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 13, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.