Provider Demographics
NPI:1194888131
Name:RIPPLE, STEVEN EDWARD (DDS)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:EDWARD
Last Name:RIPPLE
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 1:10522 S GLENSTONE PL
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70810-2875
Mailing Address - Country:US
Mailing Address - Phone:225-769-5377
Mailing Address - Fax:225-769-7910
Practice Address - Street 1:10522 S GLENSTONE PL
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70810-2875
Practice Address - Country:US
Practice Address - Phone:225-769-5377
Practice Address - Fax:225-769-7910
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA38791223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1838799Medicaid