Provider Demographics
NPI:1891272720
Name:CRISTEL, RIPP (DDS)
Entity Type:Individual
Prefix:
First Name:RIPP
Middle Name:
Last Name:CRISTEL
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 1:11585 BARKLEY LN NW
Mailing Address - Street 2:
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98332-9529
Mailing Address - Country:US
Mailing Address - Phone:253-363-6258
Mailing Address - Fax:
Practice Address - Street 1:930 PARK AVE
Practice Address - Street 2:
Practice Address - City:BREMERTON
Practice Address - State:WA
Practice Address - Zip Code:98337-1551
Practice Address - Country:US
Practice Address - Phone:360-377-7621
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-24
Last Update Date:2018-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE608626071223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice