Provider Demographics
NPI:1124293659
Name:RIPPS, DANIEL (DDS)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:RIPPS
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 1:1101 PENINSULA DR
Mailing Address - Street 2:STE 210
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16505-4169
Mailing Address - Country:US
Mailing Address - Phone:814-833-7540
Mailing Address - Fax:
Practice Address - Street 1:1101 PENINSULA DR
Practice Address - Street 2:STE 210
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16505-4169
Practice Address - Country:US
Practice Address - Phone:814-833-7540
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-25
Last Update Date:2008-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS021986L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist