Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 2011-00545 | NC |
N | 1223S0112X | Oral and Maxillofacial Surgeon | 9283 | TN |
N | 204E00000X | Oral & Maxillofacial Surgeon | 2011-00545 | NC |
N | 204E00000X | Oral & Maxillofacial Surgeon | 47509 | TN |
NPI | 1588874903 |
---|---|
Provider Name | Dr. Jason L Ringeman |
First Address | Winston Salem, NC 27103-4012 |
Second Address | Winston Salem, NC 27103-4012 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2007 |
Last Update Date | 03/09/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
07056 | (05) | LA |