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DR. JACQUELYN L RICHARDSON DDS
NPI 1780853366
Dentist in Moline, IL

Active since February 27, 2008PECOS Enrolled
609 35TH AVE STE 3, MOLINE, IL 61265(309) 762-3015(309) 762-1461 Get Directions Write a Review

NPPES record last updated: August 20, 2014. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Jacquelyn L Richardson Dds NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. JACQUELYN L RICHARDSON DDS (NPI 1780853366) is an individual dentist in Moline, Illinois, licensed in Illinois (019-026572) and active in the NPI registry since February 2008. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1780853366
Entity TypeIndividualFemale
Primary Taxonomy122300000X
Provider Legal NameDR. JACQUELYN L RICHARDSONCredential: DDS
Location Address609 35TH AVE STE 3Moline, IL 61265-6146
Mailing Address609 35th Ave Ste 3Moline, IL 61265-6146 · (309) 762-3015 · Fax (309) 762-1461
Phone(309) 762-3015
Fax(309) 762-1461
Sole ProprietorYes
Enumeration DateFebruary 27, 2008
Last NPPES UpdateAugust 20, 2014
✔ NPI 1780853366 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
License✔ Licensed in IL · 019-026572
Definition
A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.
609 35TH AVE STE 3, Moline, IL 61265
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Other Identifiers 1

Medicaid9182564IL

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Jacquelyn L Richardson Dds is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 61265 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$85.71 typical visit price
range $54.80 – $168.44
Typical copayment $21.42 (range $13.70 – $42.11)
Most-billed visit code 99203
Established Patient
$68.64 typical visit price
range $17.16 – $136.56
Typical copayment $17.16 (range $4.29 – $34.14)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jacquelyn Richardson's NPI number?

The NPI number for Jacquelyn Richardson is 1780853366. It was assigned to this individual provider in the NPPES registry on February 27, 2008.

Where is Jacquelyn Richardson located?

Jacquelyn Richardson practices at 609 35th Ave Ste 3, Moline, IL 61265. The listed phone number is (309) 762-3015.

What is Jacquelyn Richardson's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Is Jacquelyn Richardson enrolled in Medicare?

Yes. Jacquelyn Richardson is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jacquelyn Richardson was last updated on August 20, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.