Charles G Riddle, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

WV2960 Issued in WV

Practice address

415 Main St
Summersville, WV 26651-1343

Phone

(304) 872-1663

Fax

(304) 872-1804

NPI assigned

Aug 16, 2006

Last updated

Jun 18, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Cabin Creek Health Center, Inc.

  dba Westside Health Center

  • Federally Qualified Health Center (FQHC)
  • Charleston, WV
  • NPI 1194596759
  NPD (past)
• Cabin Creek Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Dawes, WV
  • NPI 1366495525
  NPD (past)
• Riddle Montgomery Metheny DDS Inc

  dba Family Dental Practice Inc

  • Dentist
  • Elkins, WV
  • NPI 1134284714
  NPD (past)

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623974400000",
    "number": "1346353125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10003 WEBSTER RD",
            "city": "CAMDEN ON GAULEY",
            "state": "WV",
            "postal_code": "262087713",
            "telephone_number": "304-226-5725",
            "fax_number": "304-226-3274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 MAIN ST",
            "city": "SUMMERSVILLE",
            "state": "WV",
            "postal_code": "266511343",
            "telephone_number": "304-872-1663",
            "fax_number": "304-872-1804"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16414 Webster Rd",
            "address_purpose": "LOCATION",
            "city": "Craigsville",
            "state": "WV",
            "postal_code": "262058512",
            "country_code": "US",
            "telephone_number": "304-742-3004",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RIDDLE",
        "first_name": "CHARLES",
        "middle_name": "G",
        "name_prefix": "Mr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-16",
        "last_updated": "2021-06-18",
        "certification_date": "2021-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WV",
            "license": "WV2960",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0133133000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dreama Rice
• Leanna Mae Rice, LPN
• Rachel Richardson, APRN, PMHNP-BC
• Angela Richmond, APRN-BC
• Stephanie A Richmond
• Olivia Ridenour, COTA
• Leticia Marie Rivas-Aragon
• James E Roberts, R.PH.
• Jewell Rockhold, RN
• Martha Roop, RN

• General Practice Dentistry in Summersville, WV
• Providers in Summersville, WV by specialty
• General Practice Dentistry in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2021; 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.