Healthcare Provider Details

I. General information

NPI: 1326775263
Provider Name (Legal Business Name): MADELINE HOPE RITTER D.D.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/02/2022
Last Update Date: 08/02/2022
Certification Date: 08/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 9TH ST STE 190
DES MOINES IA
50314-2527
US

IV. Provider business mailing address

113 NE 51ST ST
ANKENY IA
50021-8101
US

V. Phone/Fax

Practice location:
  • Phone: 515-244-9136
  • Fax:
Mailing address:
  • Phone: 815-685-7612
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDDS-10030
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDDS-10030
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: