Active NPI
Ryan Martin
- Endodontics
- Brentwood, TN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- 12760
- Practice address
- 5111 Maryland Way Ste 209
Brentwood, TN 37027-7513 - Phone
- (615) 376-8865
- NPI assigned
- Jul 16, 2015
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | IN PROCESS | AZ | |
| Endodontics | 1223E0200X | D11303 | OR | |
| Endodontics | 1223E0200X | 12760 | TN | Primary |
Addresses
Primary practice location
5111 Maryland Way Ste 209
Brentwood, TN 37027-7513
Mailing address
2026 Cedarmont Dr
Franklin, TN 37067-4020
Phone (775) 881-8981
Other practice location 1
34800 Bob Wilson Dr
San Diego, CA 92134-1098
Phone (971) 400-1661
Other practice location 2
1030 29th Ave SW
Albany, OR 97321-3416
Phone (541) 924-1190
Other practice location 3
2225 NW Shevlin Park Rd Ste 140
Bend, OR 97703-7133
Phone (844) 929-3636
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| IN PROCESS | AZ | MD | Dentist |
| D11303 | OR | MD | Endodontist |
| 12760 | TN | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ross Mitchell DMD | Endodontics | Current | Accepting new patients |
| KD Endo, LLC | Endodontics | Current | Accepting new patients |
| Ryan a. Martin, DMD, LLC | Endodontics | Current | Accepting new patients |
| Brentwood Endodontics LLC | Endodontics | Current | Accepting new patients |
| Ross P. Mitchell D.M.D., LLC | Endodontics | Past | Accepting new patients |
Locations
1030 29th Ave SW
Albany, OR 97321
Phone (541) 924-1190
2225 NW Shevlin Park Rd
Ste 140
Bend, OR 97703
Phone (541) 595-8063
5111 Maryland Way
Ste 209
Brentwood, TN 37027
Phone (615) 376-8865
Organizations & group practices 5
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Endodontics
- Bend, OR
- NPI 1730802588
-
- Endodontics
- Brentwood, TN
- NPI 1386168607
-
- Endodontics
- Bend, OR
- NPI 1164231619
-
- Endodontics
- Albany, OR
- NPI 1053959585
-
- Endodontics
- Albany, OR
- NPI 1194010660
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1437004800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1748995200000",
"number": "1306220652",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2026 CEDARMONT DR",
"city": "FRANKLIN",
"state": "TN",
"postal_code": "370674020",
"telephone_number": "775-881-8981"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5111 MARYLAND WAY STE 209",
"city": "BRENTWOOD",
"state": "TN",
"postal_code": "370277513",
"telephone_number": "615-376-8865"
}
],
"practiceLocations": [
{
"address_1": "34800 Bob Wilson Dr",
"address_purpose": "LOCATION",
"city": "San Diego",
"state": "CA",
"postal_code": "921341098",
"country_code": "US",
"telephone_number": "971-400-1661",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1030 29th Ave SW",
"address_purpose": "LOCATION",
"city": "Albany",
"state": "OR",
"postal_code": "973213416",
"country_code": "US",
"telephone_number": "541-924-1190",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2225 NW Shevlin Park Rd Ste 140",
"address_purpose": "LOCATION",
"city": "Bend",
"state": "OR",
"postal_code": "977037133",
"country_code": "US",
"telephone_number": "844-929-3636",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MARTIN",
"first_name": "RYAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-07-16",
"last_updated": "2025-06-04",
"certification_date": "2025-06-04",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "AZ",
"license": "IN PROCESS",
"primary": false
},
{
"code": "1223E0200X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dentist, Endodontics",
"state": "OR",
"license": "D11303",
"primary": false
},
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "TN",
"license": "12760",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Brentwood, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.