Jayson David Ricks, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DDS-09920 Issued in IA

Practice address

5270 Elmore Ave Ste 4
Davenport, IA 52807-3437

Phone

(563) 209-9000

NPI assigned

Jun 23, 2021

Sex

Male

Sole proprietor

Yes

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 and National Provider Directory roles.

• Patel-Shah Dental Iowa PLLC

  • General Practice Dentistry
  • Davenport, IA
  • NPI 1801583869
  NPD
• LM Smiles PLLC

  • General Practice Dentistry
  • Davenport, IA
  • NPI 1437616919
  NPD (past)

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

{
    "created_epoch": "1624406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624406400000",
    "number": "1740859883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4908 MAGGIE WAY",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "527221281",
            "telephone_number": "720-666-1007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5270 ELMORE AVE STE 4",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528073437",
            "telephone_number": "563-209-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICKS",
        "first_name": "JAYSON",
        "middle_name": "DAVID",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-06-23",
        "last_updated": "2021-06-23",
        "certification_date": "2021-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "DDS-09920",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard L Kreiter MD PC
• Anna Richards, LMHC
• Peyton James Richardson
• Heather Marcelle Rickertsen, PHARM D RPH
• Mary G Ricketts III
• Samantha Ricotta, LISW
• Cassandra A Ridenour, RN IL LCPC IL LMHC I
• Todd Ridenour, MD
• Julie A Ridgley, CRNA
• Glenda R Rieck

• General Practice Dentistry in Davenport, IA
• Providers in Davenport, IA by specialty
• General Practice Dentistry in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 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.