Organization Active NPI

Stephen L Ricks DDS PC

  • General Practice Dentistry
  • Minot, ND
National Provider Identifier
1073677191
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
901533 Issued in ND
Legal business name
STEPHEN L RICKS DDS PC
Practice address
900 20TH Ave SW
Minot, ND 58701
Phone
(701) 852-2455
Fax
(701) 852-2938
NPI assigned
Dec 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Stephen Leon Ricks, DDSNPI 1366700692
Title
President
Phone
(701) 852-2455

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 901533 ND Primary

Addresses

Primary practice location

900 20TH Ave SW
Minot, ND 58701

Mailing address

900 20TH Ave SW
Minot, ND 58701
Phone (701) 852-2455

Other identifiers 1

IdentifierTypeStateIssuer
40102MedicaidND

National Provider Directory

National Provider Directory

Locations

900 20th Ave SW
Minot, ND 58701
Phone (219) 743-8959

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1073677191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 20TH AVE SW",
            "city": "MINOT",
            "state": "ND",
            "postal_code": "58701",
            "telephone_number": "701-852-2455",
            "fax_number": "701-852-2938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 20TH AVE SW",
            "city": "MINOT",
            "state": "ND",
            "postal_code": "58701",
            "telephone_number": "701-852-2455",
            "fax_number": "701-852-2938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEPHEN L RICKS DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RICKS",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "LEON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "701-852-2455",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "ND",
            "license": "901533",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40102",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Minot, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.