Active NPI
Ryan Joseph Donovan, D.M.D.
- Periodontics
- Fort Myers, FL
National Provider Identifier
1245478726
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- DN 18030
- Practice address
- 14361 Metropolis Ave Ste 3
Fort Myers, FL 33912-4453 - Phone
- (239) 931-4141
- Fax
- (239) 931-4140
- NPI assigned
- Jan 22, 2009
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | DN 18030 | FL | Primary |
Addresses
Primary practice location
14361 Metropolis Ave Ste 3
Fort Myers, FL 33912-4453
Mailing address
16312 Crown Arbor Way Apt 201
Fort Myers, FL 33908-5677
Phone (239) 470-0908
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20141119001023 | FL | Order and Referring Only - Oral Surgery | 7719109156 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN 18030 | FL | MD | Periodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1232582400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1245478726",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16312 CROWN ARBOR WAY APT 201",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339085677",
"telephone_number": "239-470-0908"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14361 METROPOLIS AVE STE 3",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339124453",
"telephone_number": "239-931-4141",
"fax_number": "239-931-4140"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DONOVAN",
"first_name": "RYAN",
"middle_name": "JOSEPH",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-01-22",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "FL",
"license": "DN 18030",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Myers, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 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.