Kristen Ritzau D.D.S., Inc.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

59541 Issued in CA

Legal business name

KRISTEN RITZAU D.D.S., INC.

Practice address

122 Avenida Cabrillo
San Clemente, CA 92672-4039

Phone

(949) 498-4110

Fax

(949) 498-8657

NPI assigned

Jul 23, 2015

Organization subpart

No

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

Authorized official

Name

Cory Ritzau

Title

Office Manager

Phone

(949) 498-4110

Specialties & licenses 1

Addresses

Other names 1

• Shoreline Dental Studio Doing business as

Tax ID family

Kristen Ritzau DDS Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Kristen Ritzau DDS, Inc.

  • Dental Clinic/Center
  • San Clemente, CA
  • NPI 1043640915
  NPD tax ID
• Kristen Ritzau, D.D.S., Inc.

  • General Practice Dentistry
  • San Clemente, CA
  • NPI 1548860414
  NPD tax ID

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

{
    "created_epoch": "1437609600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437609600000",
    "number": "1992180608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 AVENIDA CABRILLO",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926724039",
            "telephone_number": "949-498-4110",
            "fax_number": "949-498-8657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 AVENIDA CABRILLO",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926724039",
            "telephone_number": "949-498-4110",
            "fax_number": "949-498-8657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KRISTEN RITZAU D.D.S., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-23",
        "last_updated": "2015-07-23",
        "status": "A",
        "authorized_official_last_name": "RITZAU",
        "authorized_official_first_name": "CORY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "949-498-4110"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "59541",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shoreline Dental Studio",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Bronston Kopala, DC
• Melissa B Korpi, OTR/L, HAND THERAPY
• Mark S Kosins, MD
• Anna Kreutinger
• Michael L Kreutz, D.C.
• Kristen Ritzau DDS, Inc.
• Kristen Ritzau, D.D.S., Inc.
• Kristin Blaney, Individual & Family Therapy, Inc.
• Kristin Blaney, Individual & Family Therapy, Inc.
• Kristin M Massamiri

• All providers in San Clemente, CA
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2015; 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.