Active NPI
Ryan Lee Donnelly, DMD
- General Practice Dentistry
- Portland, OR
National Provider Identifier
1841346632
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- D8599
- Practice address
- 12100 SE Stevens Court, Suite 101
Ryan L Donnelly
Portland, OR 97086 - Phone
- (503) 353-9000
- Fax
- (503) 786-1873
- NPI assigned
- Jan 26, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | D8599 | OR | Primary |
Addresses
Primary practice location
12100 SE Stevens Court, Suite 101
Ryan L Donnelly
Portland, OR 97086
Mailing address
12100 SE Stevens Court, Suite 101
Ryan L. Donnelly Co Mt. Scott Family Dental
Portland, OR 97086
Phone (503) 353-9000
Other names 1
- Ryan Donnely
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D8599 | OR | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mt. Scott Family Dental, LLC | General Practice | Past | 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": "1169769600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1692576000000",
"number": "1841346632",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12100 SE STEVENS COURT, SUITE 101",
"address_2": "RYAN L. DONNELLY CO MT. SCOTT FAMILY DENTAL",
"city": "PORTLAND",
"state": "OR",
"postal_code": "97086",
"telephone_number": "503-353-9000",
"fax_number": "503-786-1873"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12100 SE STEVENS COURT, SUITE 101",
"address_2": "RYAN L DONNELLY",
"city": "PORTLAND",
"state": "OR",
"postal_code": "97086",
"telephone_number": "503-353-9000",
"fax_number": "503-786-1873"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DONNELLY",
"first_name": "RYAN",
"middle_name": "LEE",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-26",
"last_updated": "2023-08-21",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "OR",
"license": "D8599",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "RYAN",
"last_name": "DONNELY",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.