Kristen Ritzau, D.D.S., Inc.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

KRISTEN RITZAU, D.D.S., INC.

Doing business as

Shoreline Dental Studio

Practice address

122 Avenida Cabrillo
San Clemente, CA 92672

Phone

(949) 498-4110

Fax

(949) 498-8657

NPI assigned

Oct 29, 2020

Last updated

Oct 29, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Cory Ritzau

Title

C.E.O.

Phone

(949) 498-4110

Specialties & licenses 1

Addresses

Other names 1

• Shoreline Dental Studio Doing business as

Tax ID family

Kristen Ritzau DDS Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Kristen Ritzau D.D.S., Inc.

  dba Shoreline Dental Studio

  • General Practice Dentistry
  • San Clemente, CA
  • NPI 1992180608
  NPD tax ID
• Kristen Ritzau DDS, Inc.

  • Dental Clinic/Center
  • San Clemente, CA
  • NPI 1043640915
  NPD tax ID

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

{
    "created_epoch": "1603929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603929600000",
    "number": "1548860414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 AVENIDA CABRILLO",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "92672",
            "telephone_number": "949-498-4110",
            "fax_number": "949-498-8657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 AVENIDA CABRILLO",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "92672",
            "telephone_number": "949-498-4110",
            "fax_number": "949-498-8657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KRISTEN RITZAU, D.D.S., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-29",
        "last_updated": "2020-10-29",
        "certification_date": "2020-10-27",
        "status": "A",
        "authorized_official_last_name": "RITZAU",
        "authorized_official_first_name": "CORY",
        "authorized_official_title_or_position": "C.E.O.",
        "authorized_official_telephone_number": "949-498-4110"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shoreline Dental Studio",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mark S Kosins, MD
• Anna Kreutinger
• Michael L Kreutz, D.C.
• Kristen Ritzau D.D.S., Inc. (Shoreline Dental Studio)
• Kristen Ritzau DDS, Inc.
• Kristin Blaney, Individual & Family Therapy, Inc.
• Kristin Blaney, Individual & Family Therapy, Inc.
• Kristin M Massamiri (Wheenk Physical Therapy)
• Kathleen Krueger, HHP
• Torsten J Kruse, M.D.

• General Practice Dentistry in San Clemente, CA
• Providers in San Clemente, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 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.