Evan Ridge

Primary specialty

DentistTaxonomy code 122300000X

License

DS041185 Issued in PA

Practice address

1601 Walnut St Ste 1302
Philadelphia, PA 19102-2908

Phone

(215) 568-6222

NPI assigned

Feb 2, 2016

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Dr. Ken Cirka DMD

  • Dentist
  • Phila, PA
  • NPI 1306981840
  NPD (past)

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

{
    "created_epoch": "1454371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600387200000",
    "number": "1235597477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 WALNUT ST STE 1302",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191022908",
            "telephone_number": "215-568-6222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 WALNUT ST STE 1302",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191022908",
            "telephone_number": "215-568-6222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIDGE",
        "first_name": "EVAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-02-02",
        "last_updated": "2020-09-18",
        "certification_date": "2020-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS041185",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ride4Health Philadelphia North
• Barbara Rideout, C.R.N.P.
• Robert Lawrence Rider, PH.D.
• Isabel Ridge Creamer
• Ridge Discount Pharmacy LLC
• John Andrew Ridge, M.D.
• Evelyn Brooks Ridgeway, PH.D.
• Forrest N Ridgway, PHARMD
• Maria Ridilla
• Todd W Ridky, MD

• Dentist in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Dentist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 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.