Individual provider Active NPI

Ryan Von Feldt, D.D.S

  • Dentist
  • Lakewood, CO
National Provider Identifier
1508319146
Registry record updated Aug 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DEN.00202948 Issued in CO
Practice address
5392 S Wadsworth Blvd
Unit 103
Lakewood, CO 80123-1203
Phone
(303) 979-4277
NPI assigned
Aug 1, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DEN.00202948 CO Primary

Addresses

Primary practice location

5392 S Wadsworth Blvd
Unit 103
Lakewood, CO 80123-1203

Mailing address

2216 S Downing St
Denver, CO 80210-4530

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20170403001554 CO Order and Referring Only - DentistPractitioner - Dentist 2961787056

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DEN.00202948COMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1470009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470009600000",
    "number": "1508319146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2216 S DOWNING ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802104530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5392 S WADSWORTH BLVD",
            "address_2": "UNIT 103",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "801231203",
            "telephone_number": "303-979-4277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VON FELDT",
        "first_name": "RYAN",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-01",
        "last_updated": "2016-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CO",
            "license": "DEN.00202948",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, CO

Sources for this page

Verify at the official NPI Registry.