Provider Demographics
NPI:1093375321
Name:RITTER, JAMES D (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:D
Last Name:RITTER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3694 HAYNES RD
Mailing Address - Street 2:
Mailing Address - City:BARTLETT
Mailing Address - State:TN
Mailing Address - Zip Code:38133-2751
Mailing Address - Country:US
Mailing Address - Phone:210-885-9054
Mailing Address - Fax:
Practice Address - Street 1:8135 WALNUT GROVE RD STE 4
Practice Address - Street 2:
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38018-4262
Practice Address - Country:US
Practice Address - Phone:901-755-3626
Practice Address - Fax:901-755-7870
Is Sole Proprietor?:No
Enumeration Date:2019-06-18
Last Update Date:2019-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
126800000X
TN11077122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No126800000XDental ProvidersDental Assistant