Ryan Thomas Braden

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

5908 Issued in WI

Practice address

101 Broad St
Suite 203
Lake Geneva, WI 53147-2000

Phone

(262) 248-0120

Fax

(262) 249-0140

NPI assigned

Sep 16, 2008

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

Other names 1

• Ryan Thomas Braden Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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 and National Provider Directory roles.

• Braden Dental Center SC

  • Dental Clinic/Center
  • Lake Geneva, WI
  • NPI 1679793632
  NPD (past)

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

{
    "created_epoch": "1221523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221523200000",
    "number": "1710136585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 BROAD ST",
            "address_2": "SUITE 203",
            "city": "LAKE GENEVA",
            "state": "WI",
            "postal_code": "531472000",
            "telephone_number": "262-248-0120",
            "fax_number": "262-249-0140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 BROAD ST",
            "address_2": "SUITE 203",
            "city": "LAKE GENEVA",
            "state": "WI",
            "postal_code": "531472000",
            "telephone_number": "262-248-0120",
            "fax_number": "262-249-0140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADEN",
        "first_name": "RYAN",
        "middle_name": "THOMAS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-16",
        "last_updated": "2008-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "5908",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RYAN",
            "last_name": "BRADEN",
            "middle_name": "THOMAS",
            "credential": "DDS",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Kenneth B. Bortin, MD
• Susan Lynn Bosman, OTR
• Braden Dental Center SC
• Amanda J Braden, OTR/L
• Mark Thomas Braden, DDS
• Joseph S Brantman, M.D.
• Brenda Brauer
• Bridgelight Counseling
• Bridgelight Counseling
• Donna J Brown, DC

• General Practice Dentistry in Lake Geneva, WI
• Providers in Lake Geneva, WI by specialty
• General Practice Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2008; 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.