Individual provider Active NPI

Richard Brian Ariza

  • General Practice Dentistry
  • Franklin, WI
National Provider Identifier
1902309685
Registry record updated Sep 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
1001944 Issued in WI
Practice address
6855 S 27TH St
Franklin, WI 53132-8045
Phone
(414) 435-0787
NPI assigned
Mar 9, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X MD
General Practice Dentistry 1223G0001X 1001944 WI Primary

Addresses

Primary practice location

6855 S 27TH St
Franklin, WI 53132-8045

Mailing address

20 Beaverdale LN
Stony Brook, NY 11790-2507
Phone (917) 519-6063

Other practice location 1

Stony Brook School of Dental Medicine
151 Westchester Hall
Stony Brook, NY 11794
Phone (631) 444-2557

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20181107003674 WI Order and Referring Only - DentistPractitioner - Dentist 6800140906

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1001944WIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Dental Associates LTD of Wisconsin General Practice PastSince Nov 7, 2015 Accepting new patients
Stat Anesthesia Specialists, LTD. Past Accepting new patients

Organizations & group practices 2

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": "1520553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538265600000",
    "number": "1902309685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 BEAVERDALE LN",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117902507",
            "telephone_number": "917-519-6063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6855 S 27TH ST",
            "city": "FRANKLIN",
            "state": "WI",
            "postal_code": "531328045",
            "telephone_number": "414-435-0787"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Stony Brook School of Dental Medicine",
            "address_2": "151 Westchester Hall",
            "address_purpose": "LOCATION",
            "city": "Stony Brook",
            "state": "NY",
            "postal_code": "11794",
            "country_code": "US",
            "telephone_number": "631-444-2557",
            "fax_number": "631-444-6013",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ARIZA",
        "first_name": "RICHARD",
        "middle_name": "BRIAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-09",
        "last_updated": "2018-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MD",
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "1001944",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Franklin, WI

Sources for this page

Verify at the official NPI Registry.