Ryan Holbrook DDS LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

RYAN HOLBROOK DDS LLC

Practice address

1504 N Church Rd Ste a
Liberty, MO 64068-7163

Phone

(816) 792-6469

NPI assigned

Apr 17, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Ryan Holbrook, DDS

Title

Dentist

Phone

(314) 409-9981

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1587081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1587081600000",
    "number": "1194345330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 OAK ST APT 311",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641083384",
            "telephone_number": "314-409-9981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1504 N CHURCH RD STE A",
            "city": "LIBERTY",
            "state": "MO",
            "postal_code": "640687163",
            "telephone_number": "816-792-6469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RYAN HOLBROOK DDS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-17",
        "last_updated": "2020-04-17",
        "certification_date": "2020-04-17",
        "status": "A",
        "authorized_official_last_name": "HOLBROOK",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "314-409-9981",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2020; 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.