Ryan David Harbertson, D.D.S.

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

60310 Issued in CA

Practice address

850 E Grand Ave
Suite a
Escondido, CA 92025-3435

Phone

(760) 741-4061

Fax

(760) 432-8764

NPI assigned

Oct 21, 2008

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

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

Medicare enrollment (NPD)

Enrolled

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.

• Bradley D. Bourcy DDS Ms and Ryan D. Harbertson DDS Ms

  • Periodontics
  • Escondido, CA
  • NPI 1417967290
  NPD (past) Authorized official

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

{
    "created_epoch": "1224547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338249600000",
    "number": "1073765053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 E GRAND AVE",
            "address_2": "SUITE A",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920253435",
            "telephone_number": "760-741-4061",
            "fax_number": "760-432-8764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 E GRAND AVE",
            "address_2": "SUITE A",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920253435",
            "telephone_number": "760-741-4061",
            "fax_number": "760-432-8764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARBERTSON",
        "first_name": "RYAN",
        "middle_name": "DAVID",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-10-21",
        "last_updated": "2012-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "AZ",
            "license": "8188",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CA",
            "license": "60310",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vanessa Hansen
• Happy Neuron Psychiatric Nursing Corp.
• Bonnie Haragos, LVN
• Farid F Harandi, DDS
• Steven Richard Harbert
• Rich Hardie, D.D.S., M.S.
• Jack Harding III, OTR/L
• Sarah D Hardman
• Susaine Ibarra Hardy, M.S., BCBA
• Mohamed Haridy

• Periodontics in Escondido, CA
• Providers in Escondido, CA by specialty
• Periodontics in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.