MEDICARE: DR. JOHN WILLIAM RINGO DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	12009038A	IN

General Provider Information

NPI Number	:	1407072051
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN WILLIAM RINGO DDS

Provider Business Mailing Address
First Line	:	6429 WINDMILL LN
Second Line	:
City	:	GRANT PARK
State	:	IL
Zip	:	60940-4418
Country	:	US
Telephone Number	:	815-465-6532
Fax Number	:	815-465-6542

Provider Business Practice Location Address
First Line	:	2001 US HIGHWAY 41
Second Line	:	SUITE F
City	:	SCHERERVILLE
State	:	IN
Zip	:	46375-2892
Country	:	US
Telephone Number	:	219-322-7658
Fax Number	:	219-322-8134

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/18/2007
Last Update Date	:	07/08/2007

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