Ryan Serra, D.M.D., M.S.

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

DN27127 Issued in FL

Practice address

9126 Town Center Pkwy Ste 101
Lakewood Ranch, FL 34202-5052

Phone

(941) 236-5695

NPI assigned

May 7, 2007

Last updated

Jul 22, 2022By 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 3

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

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

Credentials

Master of Science

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.

• Greater Columbus Periodontics, LLC, Ryan J. Serra, DMD, Ms

  • Periodontics
  • Columbus, OH
  • NPI 1184958225
  NPD (past) Authorized official
• Ronald B. Garvey, DDS, Inc.

  • Dental Clinic/Center
  • Columbus, OH
  • NPI 1558349613
  NPD (past)

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

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658448000000",
    "number": "1740493907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "129 52ND ST",
            "city": "HOLMES BEACH",
            "state": "FL",
            "postal_code": "342171716",
            "telephone_number": "614-571-5048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9126 TOWN CENTER PKWY STE 101",
            "city": "LAKEWOOD RANCH",
            "state": "FL",
            "postal_code": "342025052",
            "telephone_number": "941-236-5695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERRA",
        "first_name": "RYAN",
        "name_prefix": "Dr.",
        "credential": "D.M.D., M.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-07",
        "last_updated": "2022-07-22",
        "certification_date": "2022-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NC",
            "license": "8349",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "OH",
            "license": "30.023093",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "FL",
            "license": "DN27127",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Seek Childlife
• Segovia Orthodontics at Lakewood Ranch
• Kelley Marie Seibert
• Michelle Selvaggi, ARNP
• Serene Soul Psychiatric Services, PLLC
• Serrano Chiropractic and Wellness LLC
• Alisha Sexton, LMT
• Nancy Shahan
• Christopher Shalhoub, RPH
• Robert John Shamsey, MD

• Periodontics in Lakewood Ranch, FL
• Providers in Lakewood Ranch, FL by specialty
• Periodontics in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2022; 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.