Individual provider Active NPI

Billie Jean Roberts-Ritzema, DDS

  • General Practice Dentistry
  • Cadillac, MI
National Provider Identifier
1104039775
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2901016503 Issued in MI
Practice address
8795 Pine Ridge Dr
Cadillac, MI 49601-9777
Phone
(231) 775-5381
Fax
(231) 775-9801
NPI assigned
May 8, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 2901016503 MI Primary

Addresses

Primary practice location

8795 Pine Ridge Dr
Cadillac, MI 49601-9777

Mailing address

8795 Pine Ridge Dr
Cadillac, MI 49601-9777
Phone (231) 775-5381

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20160802002541 MI Order and Referring Only - DentistPractitioner - Dentist 8820382674

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2901016503MIMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104039775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8795 PINE RIDGE DR",
            "city": "CADILLAC",
            "state": "MI",
            "postal_code": "496019777",
            "telephone_number": "231-775-5381",
            "fax_number": "231-775-9801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8795 PINE RIDGE DR",
            "city": "CADILLAC",
            "state": "MI",
            "postal_code": "496019777",
            "telephone_number": "231-775-5381",
            "fax_number": "231-775-9801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS-RITZEMA",
        "first_name": "BILLIE",
        "middle_name": "JEAN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901016503",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cadillac, MI

Sources for this page

Verify at the official NPI Registry.