Ridge Dental Group, LTD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019024522 Issued in IL

Legal business name

RIDGE DENTAL GROUP, LTD

Practice address

2003 Ridge Road
Minooka, IL 60447

Phone

(815) 521-4292

NPI assigned

May 22, 2007

Organization subpart

No

Name

Dr. Matthew J Faith, D.D.S.

Title

Owner

Phone

(815) 521-4292

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Roxanne Marie Dyers, D.D.S.

  • Dentist
  • Minooka, IL
  • NPI 1538234117
  NPD (past)

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 15, 2008.

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1229299200000",
    "number": "1710196191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2003 RIDGE ROAD",
            "city": "MINOOKA",
            "state": "IL",
            "postal_code": "60447",
            "telephone_number": "815-521-4292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2003 RIDGE ROAD",
            "city": "MINOOKA",
            "state": "IL",
            "postal_code": "60447",
            "telephone_number": "815-521-4292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIDGE DENTAL GROUP, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-22",
        "last_updated": "2008-12-15",
        "status": "A",
        "authorized_official_last_name": "FAITH",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "815-521-4292",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019024522",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Leslie Rodriguez, LCSW
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• All providers in Minooka, IL
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2008; 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.