Individual provider Active NPI

Ryan Priemer

  • General Practice Dentistry
  • Kissimmee, FL
National Provider Identifier
1427407634
Registry record updated Mar 30, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN 21852 Issued in FL
Practice address
1050 Buenaventura Blvd
Kissimmee, FL 34743-7865
Phone
(407) 392-1780
NPI assigned
Jun 8, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2017

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 DN 21852 FL Primary

Addresses

Primary practice location

1050 Buenaventura Blvd
Kissimmee, FL 34743-7865

Mailing address

1050 Buenaventura Blvd
Kissimmee, FL 34743-7865

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20170217000000 FL Order and Referring Only - DentistPractitioner - Dentist 4385927342

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN 21852FLMDGeneral Practice Dentistry

Networks

  • Freedom Health HMO Network

NPI Registry JSON

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

{
    "created_epoch": "1465344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490832000000",
    "number": "1427407634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 BUENAVENTURA BLVD",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347437865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 BUENAVENTURA BLVD",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347437865",
            "telephone_number": "407-392-1780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRIEMER",
        "first_name": "RYAN",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-08",
        "last_updated": "2017-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN 21852",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

Verify at the official NPI Registry.