Stephen M Rydesky, Jr., DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS-016980-L Issued in PA

Practice address

5005 E Trindle Rd
Mechanicsburg, PA 17050-3622

Phone

(717) 766-2552

Fax

(717) 766-6572

NPI assigned

Nov 14, 2006

Last updated

Mar 7, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1225100647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5005 E TRINDLE RD",
            "city": "MECHANICSBURG",
            "state": "PA",
            "postal_code": "170503622",
            "telephone_number": "717-766-2552",
            "fax_number": "717-766-6572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5005 E TRINDLE RD",
            "city": "MECHANICSBURG",
            "state": "PA",
            "postal_code": "170503622",
            "telephone_number": "717-766-2552",
            "fax_number": "717-766-6572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYDESKY, JR.",
        "first_name": "STEPHEN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-14",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS-016980-L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "DS-016980-L",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristin Elizabeth Nelson Russo, DMD
• Rxtalents Group Inc.
• Megan M Ryan, CRNP
• Sandra D Rybacki, CRNP
• Christopher Ryder, M.D.
• Contessa Cheyenne Ryman
• Lydia Maria Sacavage, L.S.W.
• Sadler Health Center Corporation (Sadler Rx)
• Sadler Health Center Corporation
• Maham Saeed, MD

• General Practice Dentistry in Mechanicsburg, PA
• Providers in Mechanicsburg, PA by specialty
• General Practice Dentistry in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.