Healthcare Provider Details

I. General information

NPI: 1235796988
Provider Name (Legal Business Name): DANIEL F RITCHEY DMD, MSD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2019
Last Update Date: 05/22/2024
Certification Date: 05/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3802 PAXTON AVE STE 12A
CINCINNATI OH
45209-2399
US

IV. Provider business mailing address

156 CAMP CREEK WAY
GEORGETOWN KY
40324-8026
US

V. Phone/Fax

Practice location:
  • Phone: 513-898-1194
  • Fax:
Mailing address:
  • Phone: 513-257-9898
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number10416
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number30.025782
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number10416
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: