Ryan K Vanlaecken, D.D.S. M.S.

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

M817 Issued in SD

Practice address

600 4TH St NE Ste 103
Watertown, SD 57201-1898

Phone

(605) 882-1500

Fax

(605) 882-7090

NPI assigned

Aug 23, 2007

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Northeast Orthodontic Associates. L.L.C.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Watertown, SD
  • NPI 1831382134
  NPD (past) Authorized official
• Arnold Orthodontics

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Watertown, SD
  • NPI 1447477930
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1187827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589846400000",
    "number": "1003009903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 5TH ST NE",
            "address_2": "P O BOX 1450",
            "city": "WATERTOWN",
            "state": "SD",
            "postal_code": "572013712",
            "telephone_number": "605-882-1500",
            "fax_number": "605-882-7090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 4TH ST NE STE 103",
            "city": "WATERTOWN",
            "state": "SD",
            "postal_code": "572011898",
            "telephone_number": "605-882-1500",
            "fax_number": "605-882-7090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANLAECKEN",
        "first_name": "RYAN",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "D.D.S. M.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-23",
        "last_updated": "2020-05-19",
        "certification_date": "2020-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "SD",
            "license": "M817",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jean Vanderweide, RN
• Deidra J Vangilder, PHARMD
• Sophie Lynn Vanklompenburg
• Allison Vanlaecken-Heggelund
• Robert Stephen Vanlaecken, D.D.S.
• Michael J Vener, MD
• Jillian M Viessman
• Andrea Michelle Vosberg, MA, CCC-SLP
• Henry P Voss, CRNA
• W-J Optical

• Orthodontics and Dentofacial Orthopedics Dentistry in Watertown, SD
• Providers in Watertown, SD by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.