Provider Demographics
NPI:1699797688
Name:RITTENBERRY, JENNIFER TAEKO (MD)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:TAEKO
Last Name:RITTENBERRY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:7281 SAWMILL RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43016-9021
Mailing Address - Country:US
Mailing Address - Phone:614-764-0707
Mailing Address - Fax:614-764-1707
Practice Address - Street 1:7281 SAWMILL RD
Practice Address - Street 2:SUITE 100
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43016-9021
Practice Address - Country:US
Practice Address - Phone:614-764-0707
Practice Address - Fax:614-764-1707
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2021-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-082265207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2466013Medicaid
OHRI7321191Medicare PIN
OHI04349Medicare UPIN