Ryan Green, DMD
Individual provider Active NPI General Practice Dentistry · Highland, UT
NPI 1093557589 · NPPES record last updated Jun 7, 2024
Key facts
- NPI
- 1093557589
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 13921187-9926 (UT)
- Practice address
- 5455 W 11000 N Ste 202
Highland, UT 84003-8802 - Phone
- (801) 492-0055
- NPI assigned
- Jun 7, 2024
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13921187-9926 | UT | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 13921187-9926 | UT | Yes |
Addresses
Primary practice location
5455 W 11000 N Ste 202
Highland, UT 84003-8802
Mailing address
482 N 20 W
Vineyard, UT 84059-6546
Phone (435) 619-6025
Other providers in Highland, UT
- Kevin Jay Fromm
- Edward M Gillis
- Carson James Gneiting
- Leah Marie Gonzalez
- Kristin Gourley
- Claire S Groll
- Gregory G Halls
- Harris Orthodontics, PLLC
- Dallin Harris
- Mary Ann Hayes
All providers in Highland, UT · General Practice Dentistry in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 7, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.