Ryan Brooks McMahan, DDS. MS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2901020951 Issued in MI

Practice address

400 W Main St Ste 106
Gaylord, MI 49735-1870

Phone

(989) 731-6741

Fax

(989) 731-5235

NPI assigned

Jul 9, 2013

Last updated

Jan 31, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Enrolled in MI

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

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1373328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548892800000",
    "number": "1396186292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 W MAIN ST STE 106",
            "city": "GAYLORD",
            "state": "MI",
            "postal_code": "497351870",
            "telephone_number": "989-731-6741",
            "fax_number": "989-731-5235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 W MAIN ST STE 106",
            "city": "GAYLORD",
            "state": "MI",
            "postal_code": "497351870",
            "telephone_number": "989-731-6741",
            "fax_number": "989-731-5235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMAHAN",
        "first_name": "RYAN",
        "middle_name": "BROOKS",
        "name_prefix": "Dr.",
        "credential": "DDS. MS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-07-09",
        "last_updated": "2019-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "MI",
            "license": "2901020951",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901020951",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle McCarry, RN
• Clorissa M McEachern, CPNP-PC
• McLaren Central Michigan (McLaren Northern Michigan - Gaylord Family Medicine)
• Roxanne McLintock, LBSW
• Dylan McMahan, DDS
• Pamela Anne McMillan, M.A., ED. SPEC.
• Michael John McNamara, RPH
• McNamara, Visconti & Associates PLC
• Breez McPherson, CADC-DP
• Mark David McPherson, M.ED

• General Practice Dentistry in Gaylord, MI
• Providers in Gaylord, MI by specialty
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2019; 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.