Active NPI
Ryan Price
- Pediatric Dentistry
- Lake Stevens, WA
National Provider Identifier
1639665383
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- DE60877925
- Practice address
- 22 95TH Dr NE
Lake Stevens, WA 98258 - Phone
- (425) 512-9887
- NPI assigned
- Jul 5, 2018
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DE60877925 | WA | |
| Pediatric Dentistry | 1223P0221X | DE60877925 | WA | Primary |
Addresses
Primary practice location
22 95TH Dr NE
Lake Stevens, WA 98258
Mailing address
11519 22ND St SE
Lake Stevens, WA 98258-7411
Other practice location 1
111 SE Everett Mall Way # D
Everett, WA 98208-3208
Phone (425) 212-1810
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DE60877925 | Medicaid | WA |
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 |
|---|---|---|---|
| DE60877925 | WA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sonu Lamba and Paul S. Kahlon, PS | Pediatric Dentistry | Past | Accepting new patients |
| Paul Lund DDS PLLC | Pediatric Dentistry | 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 and National Provider Directory roles.
-
- Pediatric Dentistry
- Everett, WA
- NPI 1245517622
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1530748800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1571875200000",
"number": "1639665383",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11519 22ND ST SE",
"city": "LAKE STEVENS",
"state": "WA",
"postal_code": "982587411"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22 95TH DR NE",
"city": "LAKE STEVENS",
"state": "WA",
"postal_code": "98258",
"telephone_number": "425-512-9887"
}
],
"practiceLocations": [
{
"address_1": "111 SE Everett Mall Way # D",
"address_purpose": "LOCATION",
"city": "Everett",
"state": "WA",
"postal_code": "982083208",
"country_code": "US",
"telephone_number": "425-212-1810",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PRICE",
"first_name": "RYAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-07-05",
"last_updated": "2019-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "WA",
"license": "DE60877925",
"primary": false
},
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "WA",
"license": "DE60877925",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "DE60877925",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lake Stevens, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 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.