Ryan Dental, LLC

Primary specialty

DentistTaxonomy code 122300000X

License

11394 Issued in MN

Legal business name

RYAN DENTAL, LLC

Doing business as

Broadway Dental Care

Practice address

216 Broadway Ave N
Rochester, MN 55906-3646

Phone

(507) 289-5838

NPI assigned

Jun 7, 2017

Organization subpart

No

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

Authorized official

Name

Angela L Loft

Title

Admin

Phone

(651) 303-3203

Specialties & licenses 1

Addresses

Other names 1

• Broadway Dental Care Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kelly Robert Gallagher, DDS

  • General Practice Dentistry
  • Rochester, MN
  • NPI 1295783462
  NPD (past)

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

{
    "created_epoch": "1496793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1496793600000",
    "number": "1427587195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2210 BROADWAY AVE N",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559064009",
            "telephone_number": "507-288-7379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "216 BROADWAY AVE N",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559063646",
            "telephone_number": "507-289-5838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RYAN DENTAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-07",
        "last_updated": "2017-06-07",
        "status": "A",
        "authorized_official_last_name": "LOFT",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "ADMIN",
        "authorized_official_telephone_number": "651-303-3203"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "MN",
            "license": "11394",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Broadway Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Brianna Alana Ruth
• John D Rutledge, PA
• Cassidy Margaret Ruud
• RX Team Home Health Care LLC
• Anna Ryabova, MA, LPCC
• Ava Madelynn Ryan
• Cynthia K Ryan, CRNA
• Daniel L Ryan, MS, LICSW
• Kyliee Ryan
• Meghann Therese Ryan, APRN, CNP

• Dentist in Rochester, MN
• Providers in Rochester, MN by specialty
• Dentist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2017; 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.