1093919813 NPI number — DR KIP RING

Table of content: (NPI 1093919813)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1093919813 NPI number — DR KIP RING

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DR KIP RING
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1093919813
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3522 DOVECOTE MEADOW LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DAVIE
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33328-7303
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
954-370-0485
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7500 NW 5TH ST
Provider Second Line Business Practice Location Address:
108
Provider Business Practice Location Address City Name:
PLANTATION
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33317-1612
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
954-581-7540
Provider Business Practice Location Address Fax Number:
954-581-7559
Provider Enumeration Date:
06/14/2007

Additional Information

Authorized Official

Authorized Official Last Name:
RING
Authorized Official First Name:
CHRISTIAN
Authorized Official Middle Name:
DEREK
Authorized Official Title or Position:
OWNER DENTIST
Authorized Official Telephone Number:
954-581-7540

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , with the licence number:  DN15229 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com