Active NPI
Ryan C Polman, DDS
- Dentist
- Mentor, OH
National Provider Identifier
1578185484
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 30.026122
- Practice address
- 8435 Station St
Mentor, OH 44060-4924 - Phone
- (440) 255-3111
- NPI assigned
- May 13, 2020
- Last updated
- May 13, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 30.026122 | OH | Primary |
Addresses
Primary practice location
8435 Station St
Mentor, OH 44060-4924
Mailing address
6375 Ledgewood Dr
Independence, OH 44131-3241
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30.026122 | OH | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ryan C Polman, DDS, LLC | Current | Accepting new patients | |
| Great Lake Dental Arts | Dentist | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Dentist
- Mentor, OH
- NPI 1497147219
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1589328000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1589328000000",
"number": "1578185484",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6375 LEDGEWOOD DR",
"city": "INDEPENDENCE",
"state": "OH",
"postal_code": "441313241"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8435 STATION ST",
"city": "MENTOR",
"state": "OH",
"postal_code": "440604924",
"telephone_number": "440-255-3111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POLMAN",
"first_name": "RYAN",
"middle_name": "C",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-05-13",
"last_updated": "2020-05-13",
"certification_date": "2020-05-13",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "OH",
"license": "30.026122",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mentor, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.