Mark Daniel Ryan, D.D.S.

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

019.029011 Issued in IL

Practice address

2133 Pepperrell St BLDG 3352
Jbsa Lackland, TX 78236-5313

Phone

(210) 292-6258

Fax

(210) 292-2618

NPI assigned

Dec 13, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Bernard E Ryan DDS PC

  • Dental Clinic/Center
  • Bourbonnais, IL
  • NPI 1467615716
  NPD (past)

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

{
    "created_epoch": "1355356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690502400000",
    "number": "1023354388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "MIL",
            "address_1": "PSC 808 BOX 19",
            "city": "FPO",
            "state": "AE",
            "postal_code": "096180001",
            "telephone_number": "081-811-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2133 PEPPERRELL ST BLDG 3352",
            "city": "JBSA LACKLAND",
            "state": "TX",
            "postal_code": "782365313",
            "telephone_number": "210-292-6258",
            "fax_number": "210-292-2618"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "U.S. Naval Hospital",
            "address_2": "Via Contrada Boscariello",
            "address_purpose": "LOCATION",
            "city": "Gricignano di Aversa",
            "state": "CE",
            "postal_code": "81030",
            "country_code": "IT",
            "telephone_number": "081-811-6000",
            "country_name": "Italy",
            "address_type": "FGN"
        }
    ],
    "basic": {
        "last_name": "RYAN",
        "first_name": "MARK",
        "middle_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-12-13",
        "last_updated": "2023-07-28",
        "certification_date": "2023-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "IL",
            "license": "019.029011",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019029011",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jorge Romero Jr., DNP, APRN
• Colin James Rose, MD
• Natalie Marie Roy, PH.D.
• Emily E Rucker, PSYD
• Michael J Rutter, MPAS, PA-C
• Raphael John Quinones Sabado, DO
• Gerald W. Saboe, D.O., M.P.H.
• Rene Saenz, D.D.S.
• John A Safar, D.D.S.
• Cade Adam Salmon, DDS, MS

• Orthodontics and Dentofacial Orthopedics Dentistry in Jbsa Lackland, TX
• Providers in Jbsa Lackland, TX by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2023; 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.