Individual provider Active NPI

Richard L. Emert, D.D.S.

  • Dentist
  • Statesboro, GA
National Provider Identifier
1982626883
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
012472 Issued in GA
Practice address
301 Florence Ave
Statesboro, GA 30458-5138
Phone
(912) 489-2308
Fax
(912) 764-8840
NPI assigned
Jul 23, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 012472 GA Primary
Dentist 122300000X DS0000008518 TN

Addresses

Primary practice location

301 Florence Ave
Statesboro, GA 30458-5138

Mailing address

301 Florence Ave
Statesboro, GA 30458-5138
Phone (912) 489-2308

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
012472GAMDDentist
DS0000008518TNMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1153612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1982626883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 FLORENCE AVE",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304585138",
            "telephone_number": "912-489-2308",
            "fax_number": "912-764-8840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 FLORENCE AVE",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304585138",
            "telephone_number": "912-489-2308",
            "fax_number": "912-764-8840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EMERT",
        "first_name": "RICHARD",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GA",
            "license": "012472",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TN",
            "license": "DS0000008518",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Statesboro, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.