Provider Demographics
NPI:1275540742
Name:RITTER, ANDRE VICENTE (DDS, MS, MBA, PHD)
Entity Type:Individual
Prefix:DR
First Name:ANDRE
Middle Name:VICENTE
Last Name:RITTER
Suffix:
Gender:M
Credentials:DDS, MS, MBA, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:541 E 20TH ST APT 14B
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-7616
Mailing Address - Country:US
Mailing Address - Phone:919-381-2118
Mailing Address - Fax:
Practice Address - Street 1:222 E 41ST ST FL 22
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-6739
Practice Address - Country:US
Practice Address - Phone:212-263-7552
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2020-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC00411223G0001X
NY000112-011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice