Individual provider Active NPI

Naureen Nambala Ridge, DDS

  • General Practice Dentistry
  • Benson, NC
National Provider Identifier
1063805471
Registry record updated Nov 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
9953 Issued in NC
Practice address
70 Crape Myrtle Dr
Benson, NC 27504-8034
Phone
(910) 567-6194
Fax
(910) 567-5661
NPI assigned
Mar 9, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 9953 NC Primary

Addresses

Primary practice location

70 Crape Myrtle Dr
Benson, NC 27504-8034

Mailing address

70 Crape Myrtle Dr Ste 104
Benson, NC 27504-8034
Phone (910) 567-6194

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211114000016 NC Practitioner - Dentist 8628371341 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9953NCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Tri County Community Health Council Inc CurrentSince Sep 1, 2021 Accepting new patients
Tri County Community Health Council Inc CurrentSince Sep 1, 2021 Accepting new patients

Locations

70 Crape Myrtle Dr
Benson, NC 27504
Phone (919) 938-3800

70 Crape Myrtle Dr
Ste 104
Benson, NC 27504
Phone (919) 938-0260

3331 Easy St
Dunn, NC 28334

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1425859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732233600000",
    "number": "1063805471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 CRAPE MYRTLE DR STE 104",
            "city": "BENSON",
            "state": "NC",
            "postal_code": "275048034",
            "telephone_number": "910-567-6194",
            "fax_number": "910-567-5661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 CRAPE MYRTLE DR",
            "city": "BENSON",
            "state": "NC",
            "postal_code": "275048034",
            "telephone_number": "910-567-6194",
            "fax_number": "910-567-5661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIDGE",
        "first_name": "NAUREEN",
        "middle_name": "NAMBALA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-09",
        "last_updated": "2024-11-22",
        "certification_date": "2024-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "9953",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Benson, NC

Sources for this page

Verify at the official NPI Registry.