Individual provider Active NPI

Ryan Martin

  • Endodontics
  • Brentwood, TN
National Provider Identifier
1306220652
Registry record updated Jun 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
12760 Issued in TN
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

Updated by the provider on Jun 4, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X IN PROCESS AZ
EndodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 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

LicenseStateTypeSpecialty
IN PROCESSAZMDDentist
D11303ORMDEndodontist
12760TNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ross Mitchell DMD Endodontics CurrentSince Oct 1, 2022 Accepting new patients
KD Endo, LLC Endodontics CurrentSince Jan 5, 2025 Accepting new patients
Ryan a. Martin, DMD, LLC Endodontics CurrentSince Oct 2, 2022 Accepting new patients
Brentwood Endodontics LLC Endodontics CurrentSince Jun 8, 2025 Accepting new patients
Ross P. Mitchell D.M.D., LLC Endodontics PastSince Oct 1, 2022 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.

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.

Verify at the official NPI Registry.