Individual provider Active NPI

Michael J Ryan, DDS

  • Dentist
  • Middletown, DE
National Provider Identifier
1780745836
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
G10001029 Issued in DE
Practice address
106 St Annes Church Road
Middletown, DE 19709-1495
Phone
(302) 378-8600
Fax
(302) 378-8602
NPI assigned
Dec 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X G10001029 DE Primary

Addresses

Primary practice location

106 St Annes Church Road
Middletown, DE 19709-1495

Mailing address

106 St Annes Church Road
Middletown, DE 19709-1495
Phone (302) 378-8600

Other identifiers 1

IdentifierTypeStateIssuer
0000925808MedicaidDE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
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

Enrollment IDStateProvider typePAC IDDetails
I20150521002267 DE Order and Referring Only - DentistPractitioner - Dentist 4587984182

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
G10001029DEMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Dental Management Strategies LLC PastSince Oct 4, 2020 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1780745836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 ST ANNES CHURCH ROAD",
            "city": "MIDDLETOWN",
            "state": "DE",
            "postal_code": "197091495",
            "telephone_number": "302-378-8600",
            "fax_number": "302-378-8602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 ST ANNES CHURCH ROAD",
            "city": "MIDDLETOWN",
            "state": "DE",
            "postal_code": "197091495",
            "telephone_number": "302-378-8600",
            "fax_number": "302-378-8602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYAN",
        "first_name": "MICHAEL",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "DE",
            "license": "G10001029",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0000925808",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, DE

Sources for this page

Verify at the official NPI Registry.