Ryan Angwin, D.D.S.
Individual provider Active NPI Dentist · Keller, TX
NPI 1265816482 · NPPES record last updated Jul 17, 2015
Key facts
- NPI
- 1265816482
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 31232 (TX)
- Practice address
- 681 S Main St
Suite 300
Keller, TX 76248-7036 - Phone
- (817) 741-4455
- Fax
- (817) 741-4459
- NPI assigned
- Jul 17, 2015
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 31232 | TX | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Angwin Family Dentistry P.a. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 31232 | TX | Yes |
Addresses
Primary practice location
681 S Main St
Suite 300
Keller, TX 76248-7036
Mailing address
681 S Main St
Suite 300
Keller, TX 76248-7036
Phone (817) 741-4455
Other providers in Keller, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 17, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.