Individual provider Active NPI

Ryan Warren Gerts, D.M.D.

  • Dentist
  • Winona, MN
National Provider Identifier
1609436971
Registry record updated Jun 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D14241 Issued in MN
Practice address
702 Mankato Ave
Winona, MN 55987-6570
Phone
(507) 467-3333
NPI assigned
Jun 18, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D14241 MN Primary

Addresses

Primary practice location

702 Mankato Ave
Winona, MN 55987-6570

Mailing address

702 Mankato Ave
Winona, MN 55987-6570
Phone (507) 467-3333

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

LicenseStateTypeSpecialty
D14241MNMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1560816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560816000000",
    "number": "1609436971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 MANKATO AVE",
            "city": "WINONA",
            "state": "MN",
            "postal_code": "559876570",
            "telephone_number": "507-467-3333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 MANKATO AVE",
            "city": "WINONA",
            "state": "MN",
            "postal_code": "559876570",
            "telephone_number": "507-467-3333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERTS",
        "first_name": "RYAN",
        "middle_name": "WARREN",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-18",
        "last_updated": "2019-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D14241",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winona, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2019; 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.