Ryan Matthew Nielson, DDS

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

D-4496 Issued in ID

Practice address

1411 Falls Ave E Ste 1000C
Twin Falls, ID 83301-3459

Phone

(208) 734-7415

Fax

(208) 733-1922

NPI assigned

Jun 11, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1370908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370908800000",
    "number": "1558709527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9874 E ARIZONA DR APT 624",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802476349",
            "telephone_number": "716-531-6189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1411 FALLS AVE E STE 1000C",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833013459",
            "telephone_number": "208-734-7415",
            "fax_number": "208-733-1922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIELSON",
        "first_name": "RYAN",
        "middle_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-11",
        "last_updated": "2013-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "ID",
            "license": "D-4496",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brandon Clark Nielsen, O.D.
• Ciera L Nielsen, PHARMD
• Janice Carson Nielsen, LMSW,CSW,CFLE
• Nielson Family Chiropractic Inc
• Chad J Nielson, D.C.
• Andrew W Nistler
• Cynthia M Nixon, LMSW
• Kurtis Wayne Nokes, PHARMD
• Raemi Dawn Nolevanko, FNP-C
• Heather McDonald Nope, PA-C

• Pediatric Dentistry in Twin Falls, ID
• Providers in Twin Falls, ID by specialty
• Pediatric Dentistry in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2013; 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.