Active NPI
Shelley Mae Ridenour, DDS MS
- Endodontics
- Worthington, OH
National Provider Identifier
1477762532
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- 30019139
- Practice address
- 6649 N High St
Suite 101
Worthington, OH 43085-4070 - Phone
- (614) 846-3636
- Fax
- (614) 846-3656
- NPI assigned
- May 22, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endodontics | 1223E0200X | 30019139 | OH | Primary |
Addresses
Primary practice location
6649 N High St
Suite 101
Worthington, OH 43085-4070
Mailing address
398 Highgate Avenue
Worthington, OH 43085
Phone (614) 888-1893
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Nov 10, 2015 through Nov 10, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30019139 | OH | MD | Endodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179792000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1379894400000",
"number": "1477762532",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "398 HIGHGATE AVENUE",
"city": "WORTHINGTON",
"state": "OH",
"postal_code": "43085",
"telephone_number": "614-888-1893"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6649 N HIGH ST",
"address_2": "SUITE 101",
"city": "WORTHINGTON",
"state": "OH",
"postal_code": "430854070",
"telephone_number": "614-846-3636",
"fax_number": "614-846-3656"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIDENOUR",
"first_name": "SHELLEY",
"middle_name": "MAE",
"credential": "DDS MS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-22",
"last_updated": "2013-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "OH",
"license": "30019139",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Worthington, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.