Individual provider Active NPI

Ryan Lemke, DDS

  • Dentist
  • Seattle, WA
National Provider Identifier
1588084537
Registry record updated Jun 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
60634484 Issued in WA
Practice address
1628 N 45TH St
Seattle, WA 98103-6702
Phone
(206) 632-3638
Fax
(206) 632-3638
NPI assigned
Apr 17, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 25, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 60634484 WA
Dentist 122300000X 60634484 WA Primary

Addresses

Primary practice location

1628 N 45TH St
Seattle, WA 98103-6702

Mailing address

1628 N 45TH St
Seattle, WA 98103-6702
Phone (206) 856-5126

Other practice location 1

301 W 6th Ave # Mc0242
Department of Dentistry and Oral & Maxillofacial Surger
Denver, CO 80204-5182
Phone (303) 602-8241

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
I20151005002262 CO Order and Referring Only - DentistPractitioner - Dentist 0446568836

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
60634484WAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Ryan Lemke DDS PLLC CurrentSince Jun 27, 2021 Accepting new patients
Denver Health Past Accepting new patients
Denver Health Dentist Past Accepting new patients

Locations

1628 N 45th St
Seattle, WA 98103
Phone (206) 632-3638

Organizations & group practices 3

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": "1397692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624579200000",
    "number": "1588084537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1628 N 45TH ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981036702",
            "telephone_number": "206-856-5126",
            "fax_number": "206-632-3638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1628 N 45TH ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981036702",
            "telephone_number": "206-632-3638",
            "fax_number": "206-632-3638"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "301 W 6th Ave # Mc0242",
            "address_2": "Department of Dentistry and Oral & Maxillofacial Surger",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "CO",
            "postal_code": "802045182",
            "country_code": "US",
            "telephone_number": "303-602-8241",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEMKE",
        "first_name": "RYAN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-04-17",
        "last_updated": "2021-06-25",
        "certification_date": "2021-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "60634484",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "60634484",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.