James Wayne Ridley, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

D8039 Issued in OR

Practice address

208 Nopal St
Florence, OR 97439-9660

Phone

(541) 997-6226

Fax

(541) 997-6226

NPI assigned

Apr 8, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1207612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666742400000",
    "number": "1073786364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 NOPAL ST",
            "city": "FLORENCE",
            "state": "OR",
            "postal_code": "974399660",
            "telephone_number": "541-997-6226",
            "fax_number": "541-997-4472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 NOPAL ST",
            "city": "FLORENCE",
            "state": "OR",
            "postal_code": "974399660",
            "telephone_number": "541-997-6226",
            "fax_number": "541-997-6226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIDLEY",
        "first_name": "JAMES",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-04-08",
        "last_updated": "2022-10-26",
        "certification_date": "2022-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D8039",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OR",
            "license": "D8039",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer M Rasmussen, LMT
• Jordan Marie Raymer, M.D.
• Raymond G. Mans, OD PC (Florence Reedsport Eye Clinics)
• Red Cedar Rhythm LLC
• Regency Florence LLC
• Stephen Kent Riffenburgh, M.D.
• Lynn Anne Roberts, LCSW
• Kathleen L Rodosevich, CRNA
• Jennifer Rene Rossi, PH.D.
• Mildred Helen Rowley, MD

• Dentist in Florence, OR
• Providers in Florence, OR by specialty
• Dentist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.