Ryan Samuel Adams, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DE61412065 Issued in WA

Practice address

1336 5TH St
Clarkston, WA 99403-3314

Phone

(509) 758-5011

Fax

(509) 751-9125

NPI assigned

Jun 5, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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 and National Provider Directory roles.

• Meyers-Folsom Dental Clinic

  • Dentist
  • Clarkston, WA
  • NPI 1740434125
  NPD (past)
• Pomeroy Dental Center

  • Dentist
  • Pomeroy, WA
  • NPI 1245770353
  NPD (past)

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

{
    "created_epoch": "1685923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685923200000",
    "number": "1851085682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1336 5TH ST",
            "city": "CLARKSTON",
            "state": "WA",
            "postal_code": "994033314",
            "telephone_number": "509-758-5011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1336 5TH ST",
            "city": "CLARKSTON",
            "state": "WA",
            "postal_code": "994033314",
            "telephone_number": "509-758-5011",
            "fax_number": "509-751-9125"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "813 1/2 Columbia St",
            "address_purpose": "LOCATION",
            "city": "Pomeroy",
            "state": "WA",
            "postal_code": "993473007",
            "country_code": "US",
            "telephone_number": "509-843-3495",
            "fax_number": "509-751-9125",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ADAMS",
        "first_name": "RYAN",
        "middle_name": "SAMUEL",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-05",
        "last_updated": "2023-06-05",
        "certification_date": "2023-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE61412065",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aaron M Demeyere MD
• Teresa Lynn Abel, MSW
• Melody Jean Acey, LMP LICENSED MASSAGE
• Kristen Clarissa Adams, RPH
• Kiesha Ade
• Tracy Lynn Adkins, ARNP-C
• Mohamad Altayeb Al-Hafez, MD
• Jackie L Alas, MSW
• Albertsons LLC

• General Practice Dentistry in Clarkston, WA
• Providers in Clarkston, WA by specialty
• General Practice Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 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.

Verify at the official NPI Registry.