Individual provider Active NPI

Ryann Elizabeth Vasquez, DMD

  • General Practice Dentistry
  • Diamond Bar, CA
National Provider Identifier
1003339805
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DDS101514 Issued in CA
Practice address
817 Windwood Dr
Diamond Bar, CA 91789-3253
Phone
(909) 967-8811
NPI assigned
Jul 24, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DDS101514 CA Primary

Addresses

Primary practice location

817 Windwood Dr
Diamond Bar, CA 91789-3253

Mailing address

817 Windwood Dr
Diamond Bar, CA 91789-3253
Phone (909) 967-8811

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170920001059 CA Order and Referring Only - DentistPractitioner - Dentist 5092089649

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DDS101514CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Jan Vasquez Dental Corporation General Practice Current Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1500854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1003339805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "817 WINDWOOD DR",
            "city": "DIAMOND BAR",
            "state": "CA",
            "postal_code": "917893253",
            "telephone_number": "909-967-8811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "817 WINDWOOD DR",
            "city": "DIAMOND BAR",
            "state": "CA",
            "postal_code": "917893253",
            "telephone_number": "909-967-8811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VASQUEZ",
        "first_name": "RYANN",
        "middle_name": "ELIZABETH",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-24",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "DDS101514",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Diamond Bar, CA

Sources for this page

Verify at the official NPI Registry.