Individual provider Active NPI

Paige Covington Riddle, D.D.S., M.S.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Lees Summit, MO
National Provider Identifier
1811285182
Registry record updated Jul 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
2015012809 Issued in MO
Practice address
309 SW Market St
Lees Summit, MO 64063-2315
Phone
(816) 246-4671
NPI assigned
Jul 20, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 3816 AR
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 2015012809 MO Primary

Addresses

Primary practice location

309 SW Market St
Lees Summit, MO 64063-2315

Mailing address

5005 N Piedras St
El Paso, TX 79920-5001
Phone (915) 744-6083

Other practice location 1

5005 N Piedras St
El Paso, TX 79920-5001
Phone (915) 744-6083

Other identifiers 3

IdentifierTypeStateIssuer
48834068MedicaidTX
92707564MedicaidTX
77576268MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
2015012809MOMDOrthodontics and Dentofacial Orthopedic Dentist
3816ARMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Scott V. Law, D.M.D. Missouri, LLC Orthodontics and Dentofacial Orthopedics PastSince Jul 25, 2019 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1311120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563494400000",
    "number": "1811285182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5005 N PIEDRAS ST",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799205001",
            "telephone_number": "915-744-6083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 SW MARKET ST",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640632315",
            "telephone_number": "816-246-4671"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5005 N Piedras St",
            "address_purpose": "LOCATION",
            "city": "El Paso",
            "state": "TX",
            "postal_code": "799205001",
            "country_code": "US",
            "telephone_number": "915-744-6083",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COVINGTON RIDDLE",
        "first_name": "PAIGE",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-20",
        "last_updated": "2019-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AR",
            "license": "3816",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "MO",
            "license": "2015012809",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "48834068",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "92707564",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "77576268",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lees Summit, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2019; 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.