STEPHEN RIDENOUR (NPI# 1619391869) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619391869 |
| Entity Type | Individual |
| Full Name | STEPHEN RIDENOUR |
| Credential | DDS |
| Practice Address |
788 Oakleaf Way Altoona WI 54720 |
| Mailing Address |
Po Box 1224 Eau Claire WI 54702-1224 |
| Practice Telephone | 7158348414 |
| Practice Fax Number | 7158343557 |
| Mailing Telephone | 7158348414 |
| Mailing Fax Number | 7158343557 |
| Enumeration Date | 2014-02-07 |
| Last Update Date | 2018-07-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
1001741 | WI | Dental Providers |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | 30409 | IA | Student, Health Care |
| Street Address |
788 OAKLEAF WAY |
| City | ALTOONA |
| State | WI |
| Zip Code | 54720 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316954928 | Oral and Maxillofacial Surgery Asso of Eau Claire Sc | Oral & Maxillofacial Surgery | 788 Oakleaf Way, Altoona, WI 54720 | 2006-08-03 |
| 1639241342 | Slavko Ivankovic | Dentist | 788 Oakleaf Way, Altoona, WI 54720 | 2006-11-15 |
| 1205908936 | M. Drew Millington | Dentist | 788 Oakleaf Way, Altoona, WI 54720 | 2006-11-15 |
| 1447322219 | Jeff Goetz | Dentist | 788 Oakleaf Way, Altoona, WI 54720 | 2006-11-15 |
| 1023027786 | Ian Dozier | Dentist | 788 Oakleaf Way, Altoona, WI 54720 | 2006-08-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982155248 | The Bethany-st. Joseph Corporation D/b/a Prairie Pointe Rehab Suites | Skilled Nursing Facility | 286 N. Willson Dr, Altoona, WI 54720 | 2016-10-20 |
| 1821541046 | Stephanie Meyer | Optometrist | 3063 Meadowlark Ln, #10, Altoona, WI 54720 | 2016-07-25 |
| 1952756991 | Grace Lutheran Foundation Inc | Skilled Nursing Facility | 206 North Willson Drive, Altoona, WI 54720 | 2016-04-27 |
| 1669826095 | Grace Lutheran Foundation Inc | Skilled Nursing Facility | 286 North Willson Dr., Altoona, WI 54720 | 2016-04-22 |
| 1366881781 | Ingrid Ellen Schroeder | Occupational Therapy Assistant | 1203 Bartlett Avenue, Altoona, WI 54720 | 2013-06-19 |
| 1790972099 | Assisted Living Concepts Inc | Assisted Living Facility | 342 Twin Oak Drive, Altoona, WI 54720 | 2007-10-01 |
| 1427262302 | Amanda Lynn Busse | Occupational Therapy Assistant | 2512 New Pine Drive, Altoona, WI 54720 | 2007-05-09 |
| 1740230838 | Jodi Hansen Ritsch | Family Medicine | 1476 Blazing Star Blvd, Suite 4, Altoona, WI 54720 | 2006-05-11 |
| 1225095508 | Kirsten L Taylor | Counselor | 2519 North Hillcrest Parkway, Suite 103, Altoona, WI 54720 | 2006-04-28 |
| 1811977929 | Laura Ann Smith | Pediatrics | 3085 Meadowlark Ln Ste 20, Altoona, WI 54720 | 2006-01-17 |
| Find all providers in zip 54720 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598083305 | Adam Clayton Goddard | Dentist | 901 Valley View Blvd # 100, Altoona, PA 16602-6363 | 2010-05-04 |
| 1881776227 | Joseph Kaczor | Dentist | 2606 Broad Ave, Altoona, PA 16601-1915 | 2006-10-19 |
| 1346322799 | Joseph L Kaczor, Inc PC | Dentist | 2606 Broad Ave., Altoona, PA 16601-1915 | 2006-10-19 |
| 1922132299 | Stephen M. Yovino, D.m.d. | Dentist | 901 Valley View Blvd, Altoona, PA 16602-6363 | 2007-03-16 |
| 1639241342 | Slavko Ivankovic | Dentist | 788 Oakleaf Way, Altoona, WI 54720 | 2006-11-15 |
| 1205908936 | M. Drew Millington | Dentist | 788 Oakleaf Way, Altoona, WI 54720 | 2006-11-15 |
| 1447322219 | Jeff Goetz | Dentist | 788 Oakleaf Way, Altoona, WI 54720 | 2006-11-15 |
| 1023027786 | Ian Dozier | Dentist | 788 Oakleaf Way, Altoona, WI 54720 | 2006-08-05 |
| 1760474100 | Stephen M Yovino | Dentist | 901 Valley View Blvd, Altoona, PA 16602-6363 | 2005-08-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720569783 | Greater Milwaukee Oral Surgery, L.L.C. | Dentist | 4811 S 76th St Ste 304, Greenfield, WI 53220-4350 | 2018-08-27 |
| 1124516893 | Baycare Clinic, LLP | Dentist | 636 N 12th Ave, Sturgeon Bay, WI 54235-1249 | 2018-04-27 |
| 1477065787 | Central Wisconsin Oral and Facial Surgery, LLC | Dentist | 438 Edison St, Antigo, WI 54409-1845 | 2017-10-26 |
| 1497266910 | Donald Ervin Linneman | Dentist | Center 4820 N Sherman Road, Winnebago Correction Center, Drug Abuse Correctional, Winnebago, WI 54985-0036 | 2017-10-24 |
| 1063869485 | Tyler Kalmuck | Dentist | 3637 Wilgus Ave, Sheboygan, WI 53081-3050 | 2016-05-16 |
| 1952717753 | Judson Charles Smith | Dentist | 2323 N Mayfair Rd Ste 102, Milwaukee, WI 53226 | 2014-07-01 |
| 1073930459 | Paul Pamula | Dentist | 1925 S Green Bay Rd, Mount Pleasant, WI 53406-4654 | 2014-03-24 |
| 1326473927 | Lake Geneva Dental Care, LLC | Dentist | 1454 E Huebbe Pkwy, Beloit, WI 53511-1714 | 2013-09-13 |
| 1093154601 | Matthew D Reiland | Dentist | 2921 Landmark Pl Ste 100, Madison, WI 53713-4248 | 2013-06-17 |
| 1922364363 | Ell Louis Lee | Dentist | 2361 Lost Dauphin Rd, De Pere, WI 54115-9165 | 2012-04-10 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on STEPHEN RIDENOUR.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.