IndividualActive
Jeremiah Ricketson
NPI 1659933620 · Oral and Maxillofacial Surgery (Dentist) · West Hartford, CT
Provider details
- NPI number
- 1659933620
- Entity type
- Individual
- Primary specialty
- Oral and Maxillofacial Surgery (Dentist)Dental Providers
- Sex
- Male
- Sole proprietor
- No
- License
- 2.013969 (CT)
Specialties & taxonomies
Dental Providers
Practice location
928 Farmington Ave
West Hartford, CT 06107-2227
Phone: (860) 232-4606
Approximate (ZIP-level) locationGet directions
Mailing address
1011 N University Ave
Ann Arbor, MI 48109-1078
Registry dates
- Enumerated
- 2019-07-01
- Last updated
- 2025-06-26
- Certified
- 2025-06-26
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.