Individual provider Active NPI

Ryan Richard Springer, DDS

  • General Practice Dentistry
  • Skokie, IL
National Provider Identifier
1497987689
Registry record updated Dec 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12011316A Issued in IN
Practice address
4833 Church St
Skokie, IL 60077-1357
Phone
(847) 673-7118
Fax
(847) 673-7118
NPI assigned
Aug 20, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2011

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 12011316A IN Primary

Addresses

Primary practice location

4833 Church St
Skokie, IL 60077-1357

Mailing address

4833 Church St
Skokie, IL 60077-1357
Phone (847) 673-7118

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20150203000911 IL Order and Referring Only - DentistPractitioner - Dentist 2264757822

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12011316AINMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
North Suburban Dental Associates PC General Practice Past Accepting new patients
Webster Dental Care North Suburban LTD General Practice Past 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": "1250726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323907200000",
    "number": "1497987689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4833 CHURCH ST",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600771357",
            "telephone_number": "847-673-7118",
            "fax_number": "847-673-7118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4833 CHURCH ST",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600771357",
            "telephone_number": "847-673-7118",
            "fax_number": "847-673-7118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPRINGER",
        "first_name": "RYAN",
        "middle_name": "RICHARD",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-08-20",
        "last_updated": "2011-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12011316A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Skokie, IL

Sources for this page

Verify at the official NPI Registry.