Individual provider Active NPI

Ryan C Johnstun, DDS

  • General Practice Dentistry
  • Cibolo, TX
National Provider Identifier
1043300411
Registry record updated Jan 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
39099 Issued in TX
Practice address
778 Cibolo Valley Dr Ste 119
Cibolo, TX 78108-4553
Phone
(210) 436-8823
NPI assigned
Oct 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2025

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 39099 TX Primary

Addresses

Primary practice location

778 Cibolo Valley Dr Ste 119
Cibolo, TX 78108-4553

Mailing address

778 Cibolo Valley Dr Ste 119
Cibolo, TX 78108-4553
Phone (360) 436-1008

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
39099TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Dental Health Associates of Texas, PC General Practice CurrentSince Jan 5, 2025 Accepting new patients

Locations

778 Cibolo Valley Dr
Ste 119
Cibolo, TX 78108
Phone (210) 436-8823

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": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735776000000",
    "number": "1043300411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "778 CIBOLO VALLEY DR STE 119",
            "city": "CIBOLO",
            "state": "TX",
            "postal_code": "781084553",
            "telephone_number": "360-436-1008",
            "fax_number": "360-436-1147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "778 CIBOLO VALLEY DR STE 119",
            "city": "CIBOLO",
            "state": "TX",
            "postal_code": "781084553",
            "telephone_number": "210-436-8823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSTUN",
        "first_name": "RYAN",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-13",
        "last_updated": "2025-01-02",
        "certification_date": "2025-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "39099",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cibolo, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2025; 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.