Ryan Joseph Porter, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

11632110-9921 Issued in UT

Practice address

3330 N. University Ave. Ste a
Provo, UT 84604-4454

Phone

(801) 960-3643

Fax

(801) 960-3643

NPI assigned

Jan 10, 2007

Sex

Male

Sole proprietor

Yes

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

Locations

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.

• Jardine Alliance PLLC

  • Dental Clinic/Center
  • Provo, UT
  • NPI 1801655964
  NPD
• Just for Kids Dental Group Bullhead, PLLC

  • Pediatric Dentistry
  • Bullhead City, AZ
  • NPI 1154827160
  NPD (past)
• Just for Kids Dentistry Bullhead, PLLC

  • Exclusive Provider Organization
  • Bullhead City, AZ
  • NPI 1952563132
  NPD (past)
• Just for Kids Dentistry Lake Havasu

  • Dentist
  • Lake Havasu City, AZ
  • NPI 1932354974
  NPD (past)
• San Tan Ranch Smiles LLC

  • General Practice Dentistry
  • Gilbert, AZ
  • NPI 1770758765
  NPD (past)
• Signature Arizona Dental Partners LLC

  • Dental Clinic/Center
  • Tempe, AZ
  • NPI 1104395094
  NPD (past)

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668038400000",
    "number": "1083763668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3330 N. UNIVERSITY AVE. STE A",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846044454",
            "telephone_number": "801-615-2917",
            "fax_number": "801-960-3643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3330 N. UNIVERSITY AVE. STE A",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846044454",
            "telephone_number": "801-960-3643",
            "fax_number": "801-960-3643"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3592 S Atherton Blvd",
            "address_2": "#112",
            "address_purpose": "LOCATION",
            "city": "Gilbert",
            "state": "AZ",
            "postal_code": "852977443",
            "country_code": "US",
            "telephone_number": "480-457-8600",
            "fax_number": "480-457-8629",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PORTER",
        "first_name": "RYAN",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-10",
        "last_updated": "2022-11-10",
        "certification_date": "2022-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "6110",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "UT",
            "license": "11632110-9921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy M Porter, RN
• Ashley Porter
• Gregory Porter, LCSW
• Logan Porter
• Rachel Porter
• Stuart B Porter, D.O.
• Lorien Potter
• Aaron Potts
• Richard W Potts, PHD
• Jeffrey David Poulsen, MD

• General Practice Dentistry in Provo, UT
• Providers in Provo, UT by specialty
• General Practice Dentistry in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2022; 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.