Heather Lynn Ryan, DMD

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

9369 Issued in SC

Practice address

4800 NE 20TH Ter Ste 302
Ft Lauderdale, FL 33308-4510

Phone

(954) 565-6335

NPI assigned

Aug 28, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in FL

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": "1535414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563408000000",
    "number": "1215418108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1033 ROBERTS BRANCH PKWY STE 103",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292039148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 NE 20TH TER STE 302",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333084510",
            "telephone_number": "954-565-6335"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4800 NE 20th Ter",
            "address_2": "Suite 302",
            "address_purpose": "LOCATION",
            "city": "Ft. Lauderdale",
            "state": "FL",
            "postal_code": "33308",
            "country_code": "US",
            "telephone_number": "954-565-6335",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RYAN",
        "first_name": "HEATHER",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-28",
        "last_updated": "2019-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "23304",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": "SC",
            "license": "9369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Heather.ryan@pacden.com",
            "affiliation": "N",
            "address_1": "4800 NE 20th Ter",
            "address_2": "Suite 302",
            "city": "Ft. Lauderdale",
            "state": "FL",
            "country_code": "US",
            "postal_code": "33308",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jack R Rust, PHYSICAL THERAPIST
• Chelsea Rutherford, APRN- FNP-C
• RX Care Retail Services, Inc.
• RX Depot Corp
• Cynthia Ryan, MSN, ARNP, FNP-C
• Marlin Ryan, RBT
• Yulia Rybalka
• S T E P H Inc
• S&C Medical Services Corp
• S&W Clinical Research

• Endodontics in Ft Lauderdale, FL
• Providers in Ft Lauderdale, FL by specialty
• Endodontics in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2019; 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.