Provider Demographics
NPI:1013617356
Name:RICHARDS, DENNIS JOHN II (DDS)
Entity type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:JOHN
Last Name:RICHARDS
Suffix:II
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 1:5039 HAMILTON WOLFE RD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-4456
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3543 ROOSEVELT AVE
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78214-2832
Practice Address - Country:US
Practice Address - Phone:210-922-3232
Practice Address - Fax:210-932-2168
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-06
Last Update Date:2024-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX404461223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice