Individual provider Active NPI

Ryan Shane Dowling, D.M.D.,M.D.

  • Oral and Maxillofacial Surgery (Dentist)
  • Salt Lake City, UT
National Provider Identifier
1245424498
Registry record updated Jun 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
11109 Issued in TN
Practice address
2180 Fort Union Blvd
Salt Lake City, UT 84121-3148
Phone
(801) 944-4141
NPI assigned
Aug 30, 2007
Last updated
Jun 12, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 12, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X SINGLE SPECIALTY GROUP 1223S0112X 11109 TN Primary

Addresses

Primary practice location

2180 Fort Union Blvd
Salt Lake City, UT 84121-3148

Mailing address

210 N 2475 W
Provo, UT 84601-2235

Other practice location 1

1 Medical Park Blvd Ste 440
Bristol, TN 37620-7430
Phone (423) 218-4478

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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

Enrollment IDStateProvider typePAC IDDetails
I20160229000460 LA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 5092010199

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6241883-9922UTMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1188432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781222400000",
    "number": "1245424498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 N 2475 W",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846012235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2180 FORT UNION BLVD",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841213148",
            "telephone_number": "801-944-4141"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Medical Park Blvd Ste 440",
            "address_purpose": "LOCATION",
            "city": "Bristol",
            "state": "TN",
            "postal_code": "376207430",
            "country_code": "US",
            "telephone_number": "423-218-4478",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOWLING",
        "first_name": "RYAN",
        "middle_name": "SHANE",
        "credential": "D.M.D.,M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-30",
        "last_updated": "2026-06-12",
        "certification_date": "2026-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TN",
            "license": "11109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.