Healthcare Provider Details

I. General information

NPI: 1417173394
Provider Name (Legal Business Name): THOMAS K RINGENBERG DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2007
Last Update Date: 10/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7225 US 31 S
INDIANAPOLIS IN
46227-8685
US

IV. Provider business mailing address

7225 US 31 S
INDIANAPOLIS IN
46227-8685
US

V. Phone/Fax

Practice location:
  • Phone: 317-300-0356
  • Fax: 317-300-0356
Mailing address:
  • Phone: 317-300-0356
  • Fax: 317-300-0356

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number12008932A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number12008932A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: