Ryan Drake Nepomuceno De Leon, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

107638 Issued in CA

Practice address

10316 Mason Ave
Chatsworth, CA 91311-3305

Phone

(818) 493-1302

NPI assigned

Jul 21, 2022

Last updated

Jul 21, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Joseph Hanna DDS Inc

  dba Chatsworth Dentistry Dental Group

  • Dentist
  • Chatsworth, CA
  • NPI 1053811356
  NPD (past)

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

{
    "created_epoch": "1658361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1255066379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2162 GARNET CIR",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945918375",
            "telephone_number": "707-315-2210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10316 MASON AVE",
            "city": "CHATSWORTH",
            "state": "CA",
            "postal_code": "913113305",
            "telephone_number": "818-493-1302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE LEON",
        "first_name": "RYAN DRAKE",
        "middle_name": "NEPOMUCENO",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-07-21",
        "last_updated": "2022-07-21",
        "certification_date": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "107638",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dawn Seacrest Medical Supplies LLC
• DCS- Leanding Hands Foundation
• DCS-Westcoast LLC (Dcswc)
• Victoria Anne De la Garza, LMFT
• Marissa Stormy De la Riva, LPT
• Carlo Deantonio, MD
• Deanna Debartolo
• Dominic Ermie Deogracias, RN
• Department of Mental Health
• Devine Hospice Care, Inc.

• General Practice Dentistry in Chatsworth, CA
• Providers in Chatsworth, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.