Basic Information
Provider Information
NPI: 1306194949
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: NEHRING
FirstName: RICHARD
MiddleName: K
NamePrefix: DR.
NameSuffix:  
Credential: D.D.S.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 203 N WASHINGTON ST STE 300
Address2:  
City: SPOKANE
State: WA
PostalCode: 992010254
CountryCode: US
TelephoneNumber: 5094448888
FaxNumber: 5094447806
Practice Location
Address1: 844 6TH ST
Address2:  
City: CLARKSTON
State: WA
PostalCode: 994032013
CountryCode: US
TelephoneNumber: 2088488308
FaxNumber: 5092542595
Other Information
ProviderEnumerationDate: 08/28/2012
LastUpdateDate: 12/09/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 12/09/2019

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1223P0221X17404MTY Dental ProvidersDentistPediatric Dentistry

No ID Information.


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