Nick Ridenhour, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2021017794 Issued in MO

Practice address

15991 Manchester Rd
Ellisville, MO 63011-2446

Phone

(636) 227-2580

NPI assigned

May 19, 2021

Last updated

Jun 24, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Michael Smith DMD, LLC

  • Dental Clinic/Center
  • Belleville, IL
  • NPI 1639679087
  NPD (past)
• Thomas J Feder DDS PC

  • Dental Clinic/Center
  • Belleville, IL
  • NPI 1578734489
  NPD (past)

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

{
    "created_epoch": "1621382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624492800000",
    "number": "1699349118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15991 MANCHESTER RD",
            "city": "ELLISVILLE",
            "state": "MO",
            "postal_code": "630112446",
            "telephone_number": "636-227-2580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15991 MANCHESTER RD",
            "city": "ELLISVILLE",
            "state": "MO",
            "postal_code": "630112446",
            "telephone_number": "636-227-2580"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16 N Jackson St",
            "address_purpose": "LOCATION",
            "city": "Belleville",
            "state": "IL",
            "postal_code": "622201425",
            "country_code": "US",
            "telephone_number": "618-235-5141",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RIDENHOUR",
        "first_name": "NICK",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-05-19",
        "last_updated": "2021-06-24",
        "certification_date": "2021-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019033253",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "2021017794",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather Rehling, OTR
• Leslie Anne Reid, D.C.
• Sarah L. Renfert, M.D.
• Julia Dionne Reyna, CCC-SLP
• Patrick Rich, PT, DPT, SFMA
• Ries Orthodontics
• Charles Joseph Ries, DMD
• Jeanne Marie Ritchie
• Laura Jean Robbins, PMHNP
• Cortney Renae Robinson, PHARMD

• General Practice Dentistry in Ellisville, MO
• Providers in Ellisville, MO by specialty
• General Practice Dentistry in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 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.