Ridder Dental LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

RIDDER DENTAL LLC

Doing business as

Kokomo Family Dentistry

Practice address

604 E Boulevard Ste a
Kokomo, IN 46902-2286

Phone

(765) 864-2325

NPI assigned

Jun 22, 2022

Last updated

Jun 22, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jaclyn Kristine Ridder, DDSNPI 1790122273

Title

Owner

Phone

(317) 418-1342

Specialties & licenses 1

Addresses

Other names 1

• Kokomo Family Dentistry Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jaclyn Kristine Ridder, DDS

  • General Practice Dentistry
  • Noblesville, IN
  • NPI 1790122273
  NPD Authorized official
• Raymond L Christine, DDS

  • General Practice Dentistry
  • Kokomo, IN
  • NPI 1083641120
  NPD (past)

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

{
    "created_epoch": "1655856000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655856000000",
    "number": "1760113534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6706 JUNE ROSE CT",
            "city": "NOBLESVILLE",
            "state": "IN",
            "postal_code": "460629512",
            "telephone_number": "317-418-1342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604 E BOULEVARD STE A",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469022286",
            "telephone_number": "765-864-2325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIDDER DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-22",
        "last_updated": "2022-06-22",
        "certification_date": "2022-06-22",
        "status": "A",
        "authorized_official_last_name": "RIDDER",
        "authorized_official_first_name": "JACLYN",
        "authorized_official_middle_name": "KRISTINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "317-418-1342",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kokomo Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Natasha Richardson, RBT
• Sabra J Richardson, OTR
• Claire Richey
• Tina Richmond
• Mackenzie Jo Rickner, M.A., CF-SLP
• Donald W Ridenour
• Skylyn Rose Ridge
• Daniel Riffe, RBT, BS
• Tiffany Ann Rigdon
• Right Path Physical Therapy and Performance Academy LLC

• Dental Clinic/Center in Kokomo, IN
• Providers in Kokomo, IN by specialty
• Dental Clinic/Center in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2022; 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.