Ryan Michael Vaughn, D.M.D.

Primary specialty

DentistTaxonomy code 122300000X

License

DN013562 Issued in GA

Practice address

1207 Sherwood Park Dr NE
Gainesville, GA 30501-3444

Phone

(770) 862-2396

NPI assigned

Jul 19, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rvaughn41133@choa.gadirect.net

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.

• Kdnga LLC

  dba Kid's Dentistry of North Georgia

  • Pediatric Dentistry
  • Gainesville, GA
  • NPI 1598334906
  NPD

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

{
    "created_epoch": "1184803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624233600000",
    "number": "1790985620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1207 SHERWOOD PARK DR NE",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1207 SHERWOOD PARK DR NE",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013444",
            "telephone_number": "770-862-2396"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7316 Spout Springs Rd Ste 102",
            "address_purpose": "LOCATION",
            "city": "Flowery Branch",
            "state": "GA",
            "postal_code": "305425671",
            "country_code": "US",
            "telephone_number": "678-450-7011",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAUGHN",
        "first_name": "RYAN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-19",
        "last_updated": "2021-06-21",
        "certification_date": "2021-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GA",
            "license": "DN014424",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GA",
            "license": "DN013562",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003175666B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "801406612B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• William Matthew Vassy, M.D.
• Courtney Vaughan, PA
• Emily R. Vaughan, NP-C
• Matthew Lawrence Vaughn, D.M.D.
• Rebecca Leilani Vaughn, PA
• Elise Raquel Vazquez, PA
• Stephen Michael Veach, OD
• Michael J Vecchione, D.O.
• Manivannan Veerasamy, MD
• Justina Li Vega, PA-C

• Dentist in Gainesville, GA
• Providers in Gainesville, GA by specialty
• Dentist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2021; 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.