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General NPI Number Information
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NPI Number | 1821206111
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Entity Type | Individual
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Provider Name | HEATHER KECK RIDGWAY DDS, MS
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Gender | Female
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Dates
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Enumeration Date | 05/18/2007
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Last Update Date | 06/10/2025
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Provider Practice Location Address
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Address Line | 8119 ISABELLA LN STE 102
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City | BRENTWOOD
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State | TN
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Zip | 37027-8183
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Country | US
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Telephone | 615-377-7793
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Fax | 615-377-7794
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Provider Business Mailing Address
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Address Line | 8119 ISABELLA LN STE 102
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City | BRENTWOOD
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State | TN
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Zip | 37027-8183
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Country | US
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Telephone | 615-377-7793
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Fax | 615-377-7794
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 8575
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License Number State | TN
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