Rufus Paul Riddle, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2018017970 Issued in MO

Practice address

2600 Market Trce
Fort Smith, AR 72908-8681

Phone

(479) 651-8298

NPI assigned

Jun 4, 2018

Last updated

Oct 4, 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Paul Riddle DDS LLC

  dba Ottawa Kansas Dentistry

  • Dentist
  • Ottawa, KS
  • NPI 1750101705
  NPD Authorized official
• Riddle Modern Dentistry & Implants

  • Dental Clinic/Center
  • Fort Smith, AR
  • NPI 1932770609
  NPD
• Jesse Smith DDS LLC

  dba Saint Robert Family Dental Center

  • Dental Clinic/Center
  • Saint Robert, MO
  • NPI 1841778123
  NPD (past)
• Kiersz Dentistry Inc

  dba St. Robert Family Dental Center

  • General Practice Dentistry
  • Saint Robert, MO
  • NPI 1366597197
  NPD (past)

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

{
    "created_epoch": "1528070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633305600000",
    "number": "1558853671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16400 HOOVER LN",
            "city": "SAINT ROBERT",
            "state": "MO",
            "postal_code": "655844919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 MARKET TRCE",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729088681",
            "telephone_number": "479-651-8298"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "441 Marshall Dr",
            "address_purpose": "LOCATION",
            "city": "Saint Robert",
            "state": "MO",
            "postal_code": "655845603",
            "country_code": "US",
            "telephone_number": "573-336-5599",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RIDDLE",
        "first_name": "RUFUS",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-04",
        "last_updated": "2021-10-04",
        "certification_date": "2021-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "2018017970",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Talicia Richardson, MS, LAC
• Andrew Balford Riche, M.D.
• Danny M Richie, MHPP
• Kristen Ricketts
• Riddle Modern Dentistry & Implants
• Jamie L Ridgley, RN
• Sherry Riggins
• Allison Rae Riggs, APRN
• Samantha Riggs, RD
• Rebecca Rigor, MHPP

• General Practice Dentistry in Fort Smith, AR
• Providers in Fort Smith, AR by specialty
• General Practice Dentistry in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 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.