Bruce Edward Ringdahl, DDS

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

015061 Issued in MO

Practice address

201 W Broadway
Columbia, MO 65203-3842

Phone

(573) 443-1618

NPI assigned

Aug 31, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jan 26, 2017 through Jan 26, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Bruce E Ringdahl LLC

  • Periodontics
  • Columbia, MO
  • NPI 1407967003
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1023129624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 W BROADWAY",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652033842",
            "telephone_number": "573-443-1618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 W BROADWAY",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652033842",
            "telephone_number": "573-443-1618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RINGDAHL",
        "first_name": "BRUCE",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "MO",
            "license": "015061",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julie M Riley, MD
• Lyanne Riley, PH.D.
• Neil Fisher Riley, DDS
• Lori Riney
• Julia Kim Ring
• Erika N Ringdahl, M.D.
• Kayla Ringo
• Thomas J Riordan, LIC. AC.
• Jeffrey A. Rioux, LMT
• Lauren A. Ripley, LPC

• Periodontics in Columbia, MO
• Providers in Columbia, MO by specialty
• Periodontics in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.