Provider Demographics
NPI:1043484967
Name:RICHARDT, HELMUT ANTON (DDS)
Entity Type:Individual
Prefix:
First Name:HELMUT
Middle Name:ANTON
Last Name:RICHARDT
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12840 TAMIAMI TRL N
Mailing Address - Street 2:SUITE 100
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34110-1619
Mailing Address - Country:US
Mailing Address - Phone:239-591-1000
Mailing Address - Fax:239-591-8917
Practice Address - Street 1:12840 TAMIAMI TRL N
Practice Address - Street 2:SUITE 100
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34110-1619
Practice Address - Country:US
Practice Address - Phone:239-591-1000
Practice Address - Fax:239-591-8917
Is Sole Proprietor?:No
Enumeration Date:2008-04-22
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN00111521223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL650120537OtherCORPORATION TAX IDENTIFICATION NUMBER