MEDICARE: DR. AUSTIN DELMAR RIPPEON JR. DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	9279	MD

General Provider Information

NPI Number	:	1952316739
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AUSTIN DELMAR RIPPEON JR. DDS

Provider Business Mailing Address
First Line	:	180 THOMAS JOHNSON DR
Second Line	:	STE 200
City	:	FREDERICK
State	:	MD
Zip	:	21702-4409
Country	:	US
Telephone Number	:	301-663-6500
Fax Number	:	301-663-6500

Provider Business Practice Location Address
First Line	:	180 THOMAS JOHNSON DR
Second Line	:	STE 200
City	:	FREDERICK
State	:	MD
Zip	:	21702-4409
Country	:	US
Telephone Number	:	301-663-6500
Fax Number	:	301-663-6500

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/30/2006
Last Update Date	:	07/08/2007

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