Kevin William Ryan, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

DDS102063 Issued in CA

Practice address

1910 Mission Ave Ste 4
Oceanside, CA 92058-7129

Phone

(760) 631-5000

Fax

(760) 414-3885

NPI assigned

Aug 21, 2013

Sex

Male

Sole proprietor

Yes

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

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kevin.ryandmd.p1@direct.vistacommunityclinic.nextgenshare.com

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.

• Vista Community Clinic

  • Dentist
  • Oceanside, CA
  • NPI 1578198503
  NPD
• Vista Community Clinic

  • Federally Qualified Health Center (FQHC)
  • La Habra, CA
  • NPI 1497203541
  NPD (past)

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

{
    "created_epoch": "1377043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765756800000",
    "number": "1568895977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 VALE TERRACE DR",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920845218",
            "telephone_number": "760-631-5000",
            "fax_number": "760-414-3885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 MISSION AVE STE 4",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920587129",
            "telephone_number": "760-631-5000",
            "fax_number": "760-414-3885"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "815 College Blvd Ste 106",
            "address_purpose": "LOCATION",
            "city": "Oceanside",
            "state": "CA",
            "postal_code": "920576261",
            "country_code": "US",
            "telephone_number": "760-631-5000",
            "fax_number": "760-414-3885",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RYAN",
        "first_name": "KEVIN",
        "middle_name": "WILLIAM",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-08-21",
        "last_updated": "2025-12-15",
        "certification_date": "2025-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "DDS102063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patrick Joseph Russell III
• Grant Russell Rutherford, DDS, MS
• Todd Michael Ruttenberg, D.O.
• Heather Lee Ruvolo
• Erin Ryan, LCSW
• Monica Ofelia Ryan
• Eric Rypins MD Facs Apc, MD FACS APC
• Paige Elaine Sabadin, RN
• Sacral Seeds LLC
• Amalia Sacramento, REGISTERED NURSE

• Dentist in Oceanside, CA
• Providers in Oceanside, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.