Provider Demographics
NPI:1205977865
Name:RIEMANN, RICHARD ALLAN (DDS)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:ALLAN
Last Name:RIEMANN
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 1:10826 DEL RIO RD
Mailing Address - Street 2:
Mailing Address - City:SPRING VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:91978-1216
Mailing Address - Country:US
Mailing Address - Phone:619-660-6191
Mailing Address - Fax:
Practice Address - Street 1:10826 DEL RIO RD
Practice Address - Street 2:
Practice Address - City:SPRING VALLEY
Practice Address - State:CA
Practice Address - Zip Code:91978-1216
Practice Address - Country:US
Practice Address - Phone:619-660-6191
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA207181223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice