DR. RISA MAREE RECORD (NPI# 1881667053) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881667053 |
| Entity Type | Individual |
| Full Name | DR. RISA MAREE RECORD |
| Other Name | DR. RISA MAREE POORTVLIET |
| Credential | D.D.S. |
| Practice Address |
618 Dental Company (as) Unit #15662 Bldg. S137 Texas Avenue Camp Carroll APO AP 96260-5662 KR |
| Mailing Address |
162 County Road 294 Gainesville TX 76240-8436 |
| Practice Telephone | 3527657185 |
| Practice Fax Number | 3527657188 |
| Mailing Telephone | 9406122916 |
| Enumeration Date | 2006-02-08 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
BR9294353 | TX | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | AGD/TAGD NUMBER | 196626 | 01 |
| TX | DEA NUMBER | BR9294353 | 01 |
| Street Address |
618 DENTAL COMPANY (AS) UNIT #15662 BLDG. S137 TEXAS AVENUE |
| City | CAMP CARROLL |
| State | APO AP |
| Zip Code | 96260-5662 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518491984 | Aaron Vanderburg | Physician Assistant | Bldg S180 American Ave, Apo, AP 96260 | 2017-04-12 |
| 1619365327 | Gabriel Valdez | Physician Assistant | Camp Carroll Medical Clinic, Unit 15375, Apo, AP 96260 | 2015-01-05 |
| 1326239559 | Michael Alan Redd | General Practice | 501 Sbde, Hhc, Unit 15476, Box 146, Apo, AP 96260 | 2007-08-05 |
| 1063618148 | 121st Csh/baach | Clinic/Center | Unit 15662, Bldg S137, Apo, AP 96260 | 2007-06-25 |
| 1851679369 | Jun Sung Hong | Dentist | 618th Dental Company (as), Camp Carroll Dental Clinic, Apo, AP 96260 | 2011-08-01 |
| 1376612499 | Brian Allgood Army Community Hospital | Military/U.S. Coast Guard Pharmacy | Bldg 263, Apo, AP 96260-0275 | 2006-11-06 |
| 1396304846 | Danielle Sprunger | Dietitian, Registered | Unit 15375, Apo, AP 96260-5375 | 2019-06-09 |
| 1700326493 | Matthew Perdue | Physician Assistant | Hhc 2id Sbde, Unit 15476, Apo, AP 96260-5476 | 2017-03-01 |
| 1306371273 | Kyle Piecora | Psychologist | Hhc 2id Sbde, Unit 15476, Box #131, Apo, AP 96260-5476 | 2017-04-27 |
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| 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. |
| Notes: Source: Academy of General Dentistry |
| City | CAMP CARROLL |
| Zip Code | 96260 |
Please comment or provide details below to improve the information on DR. RISA MAREE RECORD.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.