Individual provider Active NPI

Ryan Michael Schmidgall, D.D.S.

  • General Practice Dentistry
  • Fort Worth, TX
National Provider Identifier
1407208911
Registry record updated Sep 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
32253 Issued in TX
Practice address
5656 Edwards Ranch Rd Ste 101
Fort Worth, TX 76109-4105
Phone
(817) 731-9487
NPI assigned
Jul 8, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 32253 TX Primary

Addresses

Primary practice location

5656 Edwards Ranch Rd Ste 101
Fort Worth, TX 76109-4105

Mailing address

5656 Edwards Ranch Rd Ste 101
Fort Worth, TX 76109-4105
Phone (817) 731-9487

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
32253TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
RMS DDS, PLLC CurrentSince Jan 1, 2020 Accepting new patients
Daniel S. Lim PLLC PastSince May 25, 2021 Accepting new patients
Country Day Dental PastSince Jan 1, 2020 Accepting new patients

Locations

4255 Bryant Irvin Rd
Ste 111
Fort Worth, TX 76109
Phone (817) 731-9487

5656 Edwards Ranch Rd
Ste 101
Fort Worth, TX 76109
Phone (817) 731-9487

Organizations & group practices 3

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": "1467936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726790400000",
    "number": "1407208911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5656 EDWARDS RANCH RD STE 101",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761094105",
            "telephone_number": "817-731-9487",
            "fax_number": "817-731-2846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5656 EDWARDS RANCH RD STE 101",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761094105",
            "telephone_number": "817-731-9487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHMIDGALL",
        "first_name": "RYAN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-08",
        "last_updated": "2024-09-20",
        "certification_date": "2024-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "32253",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2024; 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.