NPIMap

Individual provider Active NPI

Ryan Frederick Vanmoorlehem, D.M.D.

  • Endodontics
  • Spanish Fork, UT
National Provider Identifier
1053537571
Registry record updated Jun 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
5171989 Issued in UT
Practice address
826 N 100 E
Suite 3
Spanish Fork, UT 84660-1241
Phone
(801) 504-6070
Fax
(801) 504-6068
NPI assigned
Apr 17, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 5171989 UT Primary

Addresses

Primary practice location

826 N 100 E
Suite 3
Spanish Fork, UT 84660-1241

Mailing address

826 N 100 E
Suite 3
Spanish Fork, UT 84660-1241
Phone (801) 504-6070

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

State licenses

LicenseStateTypeSpecialty
5171989UTMDEndodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Alpine Endodontics Endodontics 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": "1176768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277078400000",
    "number": "1053537571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "826 N 100 E",
            "address_2": "SUITE 3",
            "city": "SPANISH FORK",
            "state": "UT",
            "postal_code": "846601241",
            "telephone_number": "801-504-6070",
            "fax_number": "801-504-6068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "826 N 100 E",
            "address_2": "SUITE 3",
            "city": "SPANISH FORK",
            "state": "UT",
            "postal_code": "846601241",
            "telephone_number": "801-504-6070",
            "fax_number": "801-504-6068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANMOORLEHEM",
        "first_name": "RYAN",
        "middle_name": "FREDERICK",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-17",
        "last_updated": "2010-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "UT",
            "license": "5171989",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spanish Fork, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2010; 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.