Bruce Levoyle Richardson, DMD01/28/1950

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

9956 Issued in OR

Practice address

3048 SW Comus St
Portland, OR 97219-7692

Phone

(503) 484-8130

NPI assigned

Sep 30, 2013

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1380499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380499200000",
    "number": "1982031316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3048 SW COMUS ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972197692",
            "telephone_number": "503-484-8130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3048 SW COMUS ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972197692",
            "telephone_number": "503-484-8130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARDSON",
        "first_name": "BRUCE",
        "middle_name": "LEVOYLE",
        "name_prefix": "Dr.",
        "credential": "DMD01/28/1950",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-09-30",
        "last_updated": "2013-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "9956",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Harold Richards, M.D.
• Robin Caitlin Richards, MD
• Stacy Louise Richards, MOT/R/L
• Tajsha Richards
• Keaton Richardson-Ray, PT, DPT, ATC, CSCS
• Cynthia Richardson, CADCI
• Heather Breanne Richardson
• Jeannette J Richardson, R.N.
• Jeremiah Richardson
• Joan Richardson, PA-C

• General Practice Dentistry in Portland, OR
• Providers in Portland, OR by specialty
• General Practice Dentistry in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.