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MARK S. RIEDERER D.D.S. NPI 1366465882


NPI Profile

NPI: 1366465882
Provider Name: MARK S. RIEDERER, D.D.S.
Classification:Dentist - 1223G0001X
Entity Type: Individual

Specialization: General Practice

Address:
9309 GLACIER HWY
B-105
JUNEAU, AK
ZIP 99801
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Phone: (907) 789-3100

Mark S. Riederer, D.D.S. is a general practice dentist in Juneau, AK. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. Mark S. Riederer, D.D.S. NPI is 1366465882. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

9309 GLACIER HWY
B-105
JUNEAU, AK
ZIP 99801-306
Phone: (907) 789-3100
Fax: (907) 789-3119

The enumeration date for this NPI number is 7/25/2006 and was last updated on 7/9/2007.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11223G0001XDentistGeneral PracticeAA651ALASKAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1DD6510MEDICAIDALASKA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/11/2021

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