Individual provider Active NPI

Ryan Andrew Dunlop, DMD

  • General Practice Dentistry
  • Fresno, CA
National Provider Identifier
1497855548
Registry record updated Mar 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
57201 Issued in CA
Practice address
6535 N. Palm Ave.
Suite 102
Fresno, CA 93704
Phone
(559) 435-3200
Fax
(559) 435-5759
NPI assigned
Sep 25, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 28, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X P51490 NY
General Practice Dentistry 1223G0001X 57201 CA Primary

Addresses

Primary practice location

6535 N. Palm Ave.
Suite 102
Fresno, CA 93704

Mailing address

6535 N. Palm Ave.
Suite 102
Fresno, CA 93704
Phone (617) 784-9135

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Mar 30, 2016 through Mar 30, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
57201CAMDGeneral Practice Dentistry
P51490NYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
RDKC, LLC Current Accepting new patients
Better Life Imaging Center PastSince Apr 6, 2023 Accepting new patients

Organizations & group practices 2

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": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679961600000",
    "number": "1497855548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6535 N. PALM AVE.",
            "address_2": "SUITE 102",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "93704",
            "telephone_number": "617-784-9135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6535 N. PALM AVE.",
            "address_2": "SUITE 102",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "93704",
            "telephone_number": "559-435-3200",
            "fax_number": "559-435-5759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUNLOP",
        "first_name": "RYAN",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-25",
        "last_updated": "2023-03-28",
        "certification_date": "2023-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "P51490",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "57201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.