Active NPI
Ryan Patrick Watkins, D.D.S.
- Dental Anesthesiology
- Vista, CA
National Provider Identifier
1104954999
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Anesthesiology
- License
- 52130
- Practice address
- 950 Vista Village Dr
Vista, CA 92084-6064 - Phone
- (760) 274-0993
- NPI assigned
- Mar 1, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 52130 | CA | |
| Dental Anesthesiology | 1223D0004X | 52130 | CA | Primary |
Addresses
Primary practice location
950 Vista Village Dr
Vista, CA 92084-6064
Mailing address
2615 Via Eco
Carlsbad, CA 92010-8348
Phone (805) 405-4975
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160621000774 | CA | Order and Referring Only - Dentist | 2466743554 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ryan Watkins DDS Inc. | General Practice | Current | Accepting new patients |
Locations
3039 Jefferson St
Ste A
Carlsbad, CA 92008
Phone (805) 405-4975
950 Vista Village Dr
Vista, CA 92084
Phone (760) 274-0993
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.
-
dba Dreamtime Dentistry Dental Group
- General Practice Dentistry
- Vista, CA
- NPI 1851698484
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172707200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1698364800000",
"number": "1104954999",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2615 VIA ECO",
"city": "CARLSBAD",
"state": "CA",
"postal_code": "920108348",
"telephone_number": "805-405-4975"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "950 VISTA VILLAGE DR",
"city": "VISTA",
"state": "CA",
"postal_code": "920846064",
"telephone_number": "760-274-0993"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATKINS",
"first_name": "RYAN",
"middle_name": "PATRICK",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-01",
"last_updated": "2023-10-27",
"certification_date": "2023-10-27",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "52130",
"primary": false
},
{
"code": "1223D0004X",
"taxonomy_group": "",
"desc": "Dentist, Dental Anesthesiology",
"state": "CA",
"license": "52130",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Vista, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2023; 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.