NPIMap

Organization Active NPI

Ryan M Clancy DMD PC

  • General Practice Dentistry
  • Medford, MA
National Provider Identifier
1487676342
Registry record updated Jan 2, 2014
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Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
20405 Issued in MA
Legal business name
RYAN M CLANCY DMD PC
Practice address
80 High St
Medford, MA 02155-3872
Phone
(781) 396-8558
Fax
(781) 396-8559
NPI assigned
Jul 23, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2014

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

Authorized official

Name
Dr. Ryan M Clancy, DMD
Title
President
Phone
(781) 396-8558

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 20405 MA Primary

Addresses

Primary practice location

80 High St
Medford, MA 02155-3872

Mailing address

80 High St
Medford, MA 02155-3872
Phone (781) 396-8558

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1153612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1388620800000",
    "number": "1487676342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 HIGH ST",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021553872",
            "telephone_number": "781-396-8558",
            "fax_number": "781-396-8559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 HIGH ST",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021553872",
            "telephone_number": "781-396-8558",
            "fax_number": "781-396-8559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RYAN M CLANCY DMD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-23",
        "last_updated": "2014-01-02",
        "status": "A",
        "authorized_official_last_name": "CLANCY",
        "authorized_official_first_name": "RYAN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "781-396-8558",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "20405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2014; 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.