Provider Demographics
NPI:1013990340
Name:RIEHL, DORAN JAMES (DDS)
Entity Type:Individual
Prefix:
First Name:DORAN
Middle Name:JAMES
Last Name:RIEHL
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 1:1016 S 40TH AVE
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98908-3877
Mailing Address - Country:US
Mailing Address - Phone:509-966-3880
Mailing Address - Fax:509-965-4353
Practice Address - Street 1:1019 S 40TH AVE
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98908-3877
Practice Address - Country:US
Practice Address - Phone:509-966-3880
Practice Address - Fax:509-965-4353
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-21
Last Update Date:2016-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA71571223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice