Ryan J Niemic, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

022448 Issued in OH

Practice address

28257 White Rd
Perrysburg, OH 43551-2977

Phone

(419) 874-0423

NPI assigned

Apr 20, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

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

State licenses

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

{
    "created_epoch": "1177027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225238400000",
    "number": "1205054939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28257 WHITE RD",
            "city": "PERRYSBURG",
            "state": "OH",
            "postal_code": "435512977",
            "telephone_number": "419-874-0423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28257 WHITE RD",
            "city": "PERRYSBURG",
            "state": "OH",
            "postal_code": "435512977",
            "telephone_number": "419-874-0423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIEMIC",
        "first_name": "RYAN",
        "middle_name": "J",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-20",
        "last_updated": "2008-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "022448",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2685910",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Perrysburg, OH
• Providers in Perrysburg, OH by specialty
• General Practice Dentistry in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2008; 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.