Organization Active NPI

Jennifer Ryan, DDS, Ms, Inc.

  • Pediatric Dentistry
  • Meadow Vista, CA
National Provider Identifier
1477041036
Registry record updated Apr 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
44771 Issued in CA
Legal business name
JENNIFER RYAN, DDS, MS, INC.
Practice address
16814 Placer Hills Rd
Meadow Vista, CA 95722-9531
Phone
(530) 878-2357
Fax
(530) 878-3910
NPI assigned
Apr 28, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2018

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

Authorized official

Name
Dr. Jennifer Lee Ryan, DDS, MSNPI 1700969706
Title
Pediatric Dentist
Phone
(530) 878-8083

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X 44771 CA Primary

Addresses

Primary practice location

16814 Placer Hills Rd
Meadow Vista, CA 95722-9531

Mailing address

16860 Lays Lake Estates LN
Meadow Vista, CA 95722-9333
Phone (530) 878-8083

National Provider Directory

National Provider Directory

Locations

16814 Placer Hills Rd
Meadow Vista, CA 95722
Phone (530) 878-2357

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1524873600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1524873600000",
    "number": "1477041036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16860 LAYS LAKE ESTATES LN",
            "city": "MEADOW VISTA",
            "state": "CA",
            "postal_code": "957229333",
            "telephone_number": "530-878-8083",
            "fax_number": "530-878-3910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16814 PLACER HILLS RD",
            "city": "MEADOW VISTA",
            "state": "CA",
            "postal_code": "957229531",
            "telephone_number": "530-878-2357",
            "fax_number": "530-878-3910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JENNIFER RYAN, DDS, MS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-28",
        "last_updated": "2018-04-28",
        "status": "A",
        "authorized_official_last_name": "RYAN",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "PEDIATRIC DENTIST",
        "authorized_official_telephone_number": "530-878-8083",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS, MS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "44771",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meadow Vista, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2018; 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.