Individual provider Active NPI

Christopher Mark Ricker, D.M.D.

  • Periodontics
  • Columbia, SC
National Provider Identifier
1629515820
Registry record updated Dec 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
10739 Issued in NC
Practice address
10 Medical Park
Dental Department
Columbia, SC 29203
Phone
(803) 434-6567
Fax
(803) 434-6299
NPI assigned
Jan 25, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 10739 NC Primary

Addresses

Primary practice location

10 Medical Park
Dental Department
Columbia, SC 29203

Mailing address

9920 Kincey Ave Ste 280
Huntersville, NC 28078-2400
Phone (704) 322-3000

Other practice location 1

9920 Kincey Ave Ste 280
Huntersville, NC 28078-2400
Phone (704) 322-3000

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

LicenseStateTypeSpecialty
10739NCMDPeriodontist

NPI Registry JSON

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

{
    "created_epoch": "1485302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764892800000",
    "number": "1629515820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9920 KINCEY AVE STE 280",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280782400",
            "telephone_number": "704-322-3000",
            "fax_number": "704-755-6533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 MEDICAL PARK",
            "address_2": "DENTAL DEPARTMENT",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "29203",
            "telephone_number": "803-434-6567",
            "fax_number": "803-434-6299"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9920 Kincey Ave Ste 280",
            "address_purpose": "LOCATION",
            "city": "Huntersville",
            "state": "NC",
            "postal_code": "280782400",
            "country_code": "US",
            "telephone_number": "704-322-3000",
            "fax_number": "704-755-6533",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RICKER",
        "first_name": "CHRISTOPHER",
        "middle_name": "MARK",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-01-25",
        "last_updated": "2025-12-05",
        "certification_date": "2025-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "NC",
            "license": "10739",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2025; 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.