Individual provider Active NPI

Richard Brandon Ford, DDS

  • General Practice Dentistry
  • Las Vegas, NV
National Provider Identifier
1831405042
Registry record updated Aug 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
LL-223-10 Issued in NV
Practice address
1707 W Charleston Blvd
Las Vegas, NV 89102-2351
Phone
(702) 774-2816
NPI assigned
Aug 25, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2010

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 LL-223-10 NV Primary

Addresses

Primary practice location

1707 W Charleston Blvd
Las Vegas, NV 89102-2351

Mailing address

1001 Shadow LN
BLDG a 204G
Las Vegas, NV 89106-4124
Phone (702) 774-2816

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20160824002211 WA Order and Referring Only - DentistPractitioner - Dentist 4880989284

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LL-223-10NVMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Unlv Medicine Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1282694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282694400000",
    "number": "1831405042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 SHADOW LN",
            "address_2": "BLDG A 204G",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891064124",
            "telephone_number": "702-774-2816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1707 W CHARLESTON BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891022351",
            "telephone_number": "702-774-2816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORD",
        "first_name": "RICHARD",
        "middle_name": "BRANDON",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-08-25",
        "last_updated": "2010-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NV",
            "license": "LL-223-10",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.