Provider Demographics
NPI:1235687500
Name:RIDGEWAY, ERIKA K (DDS)
Entity Type:Individual
Prefix:
First Name:ERIKA
Middle Name:K
Last Name:RIDGEWAY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1148 72ND ST. E
Mailing Address - Street 2:SUITE B
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98404
Mailing Address - Country:US
Mailing Address - Phone:253-537-5437
Mailing Address - Fax:253-537-5438
Practice Address - Street 1:1148 72ND ST E UNIT B
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98404-1806
Practice Address - Country:US
Practice Address - Phone:253-537-5437
Practice Address - Fax:253-537-5438
Is Sole Proprietor?:No
Enumeration Date:2016-09-15
Last Update Date:2022-07-21
Deactivation Date:2017-04-25
Deactivation Code:
Reactivation Date:2017-06-02
Provider Licenses
StateLicense IDTaxonomies
WA60680586122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist