NPIMap

Organization Active NPI

Jacob J. Ridl DDS PLLC

  • General Practice Dentistry
  • Cheney, WA
National Provider Identifier
1790239457
Registry record updated Aug 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DE60093486 Issued in WA
Legal business name
JACOB J. RIDL DDS PLLC
Practice address
1717 1St St
P.O. Box a
Cheney, WA 99004-1903
Phone
(509) 235-6241
Fax
(509) 235-6218
NPI assigned
Aug 11, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2016

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

Authorized official

Name
Jacob J. Ridl, DDS PLLCNPI 1780814582
Title
Dentist
Phone
(509) 235-6241

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X DE60093486 WA Primary

Addresses

Primary practice location

1717 1St St
P.O. Box a
Cheney, WA 99004-1903

Mailing address

1717 1St St
P.O. Box a
Cheney, WA 99004-1903
Phone (509) 235-6241

National Provider Directory

National Provider Directory

Locations

1717 1st St
Cheney, WA 99004
Phone (509) 235-6241

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1470873600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470873600000",
    "number": "1790239457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 1ST ST",
            "address_2": "P.O. BOX A",
            "city": "CHENEY",
            "state": "WA",
            "postal_code": "990041903",
            "telephone_number": "509-235-6241",
            "fax_number": "509-235-6218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 1ST ST",
            "address_2": "P.O. BOX A",
            "city": "CHENEY",
            "state": "WA",
            "postal_code": "990041903",
            "telephone_number": "509-235-6241",
            "fax_number": "509-235-6218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACOB J. RIDL DDS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-11",
        "last_updated": "2016-08-11",
        "status": "A",
        "authorized_official_last_name": "RIDL",
        "authorized_official_first_name": "JACOB",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "509-235-6241",
        "authorized_official_credential": "DDS PLLC"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE60093486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cheney, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2016; 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.