Active NPI
Jerome John Riddle, D.D.S.
- General Practice Dentistry
- Scottsdale, AZ
National Provider Identifier
1992880546
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 4217
- Practice address
- 6345 E Bell Rd
Suite #2
Scottsdale, AZ 85254-6452 - Phone
- (480) 991-4410
- Fax
- (480) 948-0982
- NPI assigned
- Oct 25, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 4217 | AZ | Primary |
Addresses
Primary practice location
6345 E Bell Rd
Suite #2
Scottsdale, AZ 85254-6452
Mailing address
6345 E Bell Rd
Suite #2
Scottsdale, AZ 85254-6452
Phone (480) 991-4410
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4217 | AZ | MD | Hearing Instrument Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jerome Riddle DDS PC | General Practice | Past | 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": "1161734400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1992880546",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6345 E BELL RD",
"address_2": "SUITE #2",
"city": "SCOTTSDALE",
"state": "AZ",
"postal_code": "852546452",
"telephone_number": "480-991-4410",
"fax_number": "480-948-0982"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6345 E BELL RD",
"address_2": "SUITE #2",
"city": "SCOTTSDALE",
"state": "AZ",
"postal_code": "852546452",
"telephone_number": "480-991-4410",
"fax_number": "480-948-0982"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIDDLE",
"first_name": "JEROME",
"middle_name": "JOHN",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-25",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "AZ",
"license": "4217",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Scottsdale, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.