Mary Therese Ryan, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

7722 Issued in IA

Practice address

2346 Mormon Trek Blvd
Suite 2600
Iowa City, IA 52246

Phone

(319) 339-4456

Fax

(319) 339-4456

NPI assigned

Apr 11, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Willow Creek Family Dentistry

  • Dental Clinic/Center
  • Iowa City, IA
  • NPI 1134853575
  NPD (past)

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

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376766923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2346 MORMON TREK BLVD",
            "address_2": "SUITE 2600",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "52246",
            "telephone_number": "319-339-4456",
            "fax_number": "319-339-4456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2346 MORMON TREK BLVD",
            "address_2": "SUITE 2600",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "52246",
            "telephone_number": "319-339-4456",
            "fax_number": "319-339-4456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYAN",
        "first_name": "MARY",
        "middle_name": "THERESE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "7722",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chelsea Rae Rutt, FNP-BC
• Kathleen Ann Ruyle, L.I.S.W.
• Mariah Ruyle, LMFT
• Jean M Ryan, RD,LD
• Katherine Ellen Ryan, PTA
• Thomas Ryan, OTR/L
• Zoe Ryan, MD
• S Ann Long Trauma Therapist Collective PLC
• Sara Saad El-Dein, MD
• Mothana Mouffaq Saad Eldine, MD

• General Practice Dentistry in Iowa City, IA
• Providers in Iowa 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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.