Amanda Rose Ryan, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

1002583-15 Issued in WI

Practice address

811 N Lynndale Dr Ste 1a
Appleton, WI 54914-3085

Phone

(920) 739-1055

NPI assigned

May 24, 2021

Last updated

Jun 18, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1621814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623974400000",
    "number": "1346815131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1435 N MCCARTHY RD APT 5",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549138285",
            "telephone_number": "413-242-8142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 N LYNNDALE DR STE 1A",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549143085",
            "telephone_number": "920-739-1055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYAN",
        "first_name": "AMANDA",
        "middle_name": "ROSE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-24",
        "last_updated": "2021-06-18",
        "certification_date": "2021-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "1002583-15",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Evelyn Yvonne Ruppel, RN
• Kathryn Lee Ruppel, LMT
• Wayne J Rusin, MD
• Kristen N Russell, APNP
• Shayla Russell
• John J. Rydlewicz, D.D.S.
• Jennifer Rose Rydzewski
• Aprill E Rykal, DC
• Jeanine Rae Rysewyk, MAC LPC
• S H Chien MD SC

• General Practice Dentistry in Appleton, WI
• Providers in Appleton, WI by specialty
• General Practice Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2021; 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.