NPIMap

Organization Active NPI

Conway Village Dental PLLC

  • Dental Clinic/Center
  • Conway, NH
National Provider Identifier
1720248248
Registry record updated Jun 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
CONWAY VILLAGE DENTAL PLLC
Practice address
7 Greenwood Ave
Suite 3
Conway, NH 03818-6130
Phone
(603) 447-6707
Fax
(603) 447-8376
NPI assigned
Jun 10, 2008
Last updated
Jun 10, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2008

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

Authorized official

Name
Dr. George Gerard Ryan Jr., DDS
Title
Owner
Phone
(603) 447-6707

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X NU Primary

Addresses

Primary practice location

7 Greenwood Ave
Suite 3
Conway, NH 03818-6130

Mailing address

7 Greenwood Ave
Suite 3
Conway, NH 03818-6130
Phone (603) 447-6707

Other identifiers 2

IdentifierTypeStateIssuer
139600000MedicaidME
99002725MedicaidNH

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1213056000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213056000000",
    "number": "1720248248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 GREENWOOD AVE",
            "address_2": "SUITE 3",
            "city": "CONWAY",
            "state": "NH",
            "postal_code": "038186130",
            "telephone_number": "603-447-6707",
            "fax_number": "603-447-8376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 GREENWOOD AVE",
            "address_2": "SUITE 3",
            "city": "CONWAY",
            "state": "NH",
            "postal_code": "038186130",
            "telephone_number": "603-447-6707",
            "fax_number": "603-447-8376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONWAY VILLAGE DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-10",
        "last_updated": "2008-06-10",
        "status": "A",
        "authorized_official_last_name": "RYAN",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "GERARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "603-447-6707",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "139600000",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "99002725",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Conway, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 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.