Ryan James Canada, D.M.D

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

09501 Issued in IA

Practice address

3500 S Lakeport St
Sioux City, IA 51106-4516

Phone

(712) 276-5547

NPI assigned

Sep 9, 2011

Last updated

Apr 11, 2019By 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 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Ryan J Canada DMD PLLC

  • Dental Clinic/Center
  • Sioux City, IA
  • NPI 1558161067
  NPD Authorized official

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

{
    "created_epoch": "1315526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554940800000",
    "number": "1356623995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3050 VALLEY DR",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "511044074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 S LAKEPORT ST",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "511064516",
            "telephone_number": "712-276-5547"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Highway 77/75",
            "address_2": "Winnebago Hospital",
            "address_purpose": "LOCATION",
            "city": "Winnebago",
            "state": "NE",
            "postal_code": "68071",
            "country_code": "US",
            "telephone_number": "402-878-2465",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CANADA",
        "first_name": "RYAN",
        "middle_name": "JAMES",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-09-09",
        "last_updated": "2019-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NV",
            "license": "6109",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NE",
            "license": "6998",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "09501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Sioux City, IA
• Providers in Sioux City, IA by specialty
• General Practice Dentistry in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2019; 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.