MEDICARE: DR. NATHAN RIEXINGER DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	063202-01	NY

General Provider Information

NPI Number	:	1578204152
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NATHAN RIEXINGER DDS

Provider Business Mailing Address
First Line	:	101 SIMME RD
Second Line	:
City	:	LANCASTER
State	:	NY
Zip	:	14086-9404
Country	:	US
Telephone Number	:	716-901-3982
Fax Number	:

Provider Business Practice Location Address
First Line	:	425 MAIN ST
Second Line	:
City	:	WEST SENECA
State	:	NY
Zip	:	14224-2822
Country	:	US
Telephone Number	:	716-674-5256
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/06/2022
Last Update Date	:	09/22/2023

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