Healthcare Provider Details

I. General information

NPI: 1083504989
Provider Name (Legal Business Name): PETER JOSEPH RITTENHOUSE DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2025
Last Update Date: 07/26/2026
Certification Date: 07/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6398 DEL CERRO BLVD STE 1
SAN DIEGO CA
92120-4760
US

IV. Provider business mailing address

8578 VILLA LA JOLLA DR APT 320
LA JOLLA CA
92037-8319
US

V. Phone/Fax

Practice location:
  • Phone: 619-286-1181
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number113013
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: