Individual provider Active NPI

Ryan Coello, DMD, MS, FACP

  • Prosthodontics
  • Boca Raton, FL
National Provider Identifier
1033527239
Registry record updated Aug 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthodonticsTaxonomy code 1223P0700X
License
DN20705 Issued in FL
Practice address
1700 S Dixie Hwy Ste 103
Boca Raton, FL 33432-7406
Phone
(561) 368-4057
NPI assigned
Jul 31, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN 20705 FL
Prosthodontics 1223P0700X DN20705 FL Primary

Addresses

Primary practice location

1700 S Dixie Hwy Ste 103
Boca Raton, FL 33432-7406

Mailing address

1700 S Dixie Hwy Ste 103
Boca Raton, FL 33432-7406
Phone (561) 368-4057

Other practice location 1

2441 21st St
Fort Campbell, KY 42223-5582
Phone (270) 412-2787

Other practice location 2

US Army Dentac Bldg 9900 Lincoln St
2nd Floor
Tacoma, WA 98431-0001
Phone (253) 968-4039

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
DN 20705FLMDDentist
DN20705FLMDProsthodontist

NPI Registry JSON

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

{
    "created_epoch": "1406764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692748800000",
    "number": "1033527239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 S DIXIE HWY STE 103",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334327406",
            "telephone_number": "561-368-4057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 S DIXIE HWY STE 103",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334327406",
            "telephone_number": "561-368-4057"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2441 21st St",
            "address_purpose": "LOCATION",
            "city": "Fort Campbell",
            "state": "KY",
            "postal_code": "422235582",
            "country_code": "US",
            "telephone_number": "270-412-2787",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "US Army Dentac Bldg 9900 Lincoln St",
            "address_2": "2nd Floor",
            "address_purpose": "LOCATION",
            "city": "Tacoma",
            "state": "WA",
            "postal_code": "984310001",
            "country_code": "US",
            "telephone_number": "253-968-4039",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COELLO",
        "first_name": "RYAN",
        "name_prefix": "Dr.",
        "credential": "DMD, MS, FACP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-31",
        "last_updated": "2023-08-23",
        "certification_date": "2023-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN 20705",
            "primary": false
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "FL",
            "license": "DN20705",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 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.