Ryan W Andris, D.M.D

Primary specialty

DentistTaxonomy code 122300000X

License

019.029393 Issued in IL

Practice address

636 W Jefferson St
Morton, IL 61550-1581

Phone

(309) 263-8317

NPI assigned

Sep 18, 2013

Last updated

Sep 24, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

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 IL

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

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.

• Andris Family Dental, LLC

  • Dental Clinic/Center
  • Morton, IL
  • NPI 1225493034
  NPD (past) Authorized official

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

{
    "created_epoch": "1379462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379980800000",
    "number": "1669808903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 SANDSTONE AVE.",
            "city": "CARLOCK",
            "state": "IL",
            "postal_code": "617252002",
            "telephone_number": "309-533-3539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "636 W JEFFERSON ST",
            "city": "MORTON",
            "state": "IL",
            "postal_code": "615501581",
            "telephone_number": "309-263-8317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDRIS",
        "first_name": "RYAN",
        "middle_name": "W",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-09-18",
        "last_updated": "2013-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019.029393",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• A Balanced Life Medical Services LLC
• Agape Counseling, LTD
• Lindsay Anderson
• Nancy J. Anderson, LCPC
• Andris Family Dental, LLC
• Aperion Care Morton Terrace LLC (Aperion Care Morton Terrace)
• Aperion Care Morton Villa LLC
• Aperion Care Morton Villa LLC (Aperion Care Morton Villa)
• Apostolic Christian Counseling and Family Services
• Apostolic Christian Home for the Handicapped

• Dentist in Morton, IL
• Providers in Morton, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2013; 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.