Charles Shubert Ricks, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

GA1358 Issued in CA

Practice address

136 S Aspen CT
Suite B
Visalia, CA 93291-5175

Phone

(559) 625-9300

Fax

(559) 625-9330

NPI assigned

Jul 28, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318464000000",
    "number": "1740294412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 S ASPEN CT",
            "address_2": "SUITE B",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932915175",
            "telephone_number": "559-625-9300",
            "fax_number": "559-625-9330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 S ASPEN CT",
            "address_2": "SUITE B",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932915175",
            "telephone_number": "559-625-9300",
            "fax_number": "559-625-9330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICKS",
        "first_name": "CHARLES",
        "middle_name": "SHUBERT",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2011-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "23135",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "GA1358",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENT-CAL",
            "identifier": "G93774-01",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Charles Leonard Rico II, DDS
• Byron William Riegel, M.D.
• Jose Pablo Rigor, DDS
• Heather Rinehart
• Rios & Powell, a Medical Corporation

• Oral and Maxillofacial Surgery (Dentist) in Visalia, CA
• Providers in Visalia, CA by specialty
• Oral and Maxillofacial Surgery (Dentist) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2011; 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.