Active NPI
Dallen Bryce Ricks, DDS
- Dentist
- Lubbock, TX
National Provider Identifier
1467896571
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 29747
- Practice address
- 2420 Quaker Ave
104
Lubbock, TX 79410-1817 - Phone
- (806) 797-0341
- NPI assigned
- Apr 18, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Dentist | 122300000X | 7125-15 | WI | |
| Dentist | 122300000X | 29747 | TX | Primary |
Addresses
Primary practice location
2420 Quaker Ave
104
Lubbock, TX 79410-1817
Mailing address
2420 Quaker Ave
104
Lubbock, TX 79410-1817
Phone (806) 797-0341
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 29747 | TX | MD | Dentist |
| 7125-15 | WI | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Yellow House Dental & Implant Center, PLLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- General Practice Dentistry
- Lubbock, TX
- NPI 1699288423
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1366243200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1443225600000",
"number": "1467896571",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2420 QUAKER AVE",
"address_2": "104",
"city": "LUBBOCK",
"state": "TX",
"postal_code": "794101817",
"telephone_number": "806-797-0341"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2420 QUAKER AVE",
"address_2": "104",
"city": "LUBBOCK",
"state": "TX",
"postal_code": "794101817",
"telephone_number": "806-797-0341"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RICKS",
"first_name": "DALLEN",
"middle_name": "BRYCE",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-04-18",
"last_updated": "2015-09-26",
"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": "WI",
"license": "7125-15",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "29747",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lubbock, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.