NPIMap

Organization Active NPI

Ryan Tracy, DMD, PLLC

  • Dentist
  • Clinton, MS
National Provider Identifier
1851562722
Registry record updated Mar 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
3072-98 Issued in MS
Legal business name
RYAN TRACY, DMD, PLLC
Practice address
104 Clinton Center Dr
Clinton, MS 39056-5627
Phone
(601) 924-0770
Fax
(601) 924-2523
NPI assigned
Mar 18, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2008

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

Authorized official

Name
Dr. Richard Ryan Tracy, DMDNPI 1427156124
Title
Owner
Phone
(601) 924-0770

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 3072-98 MS Primary

Addresses

Primary practice location

104 Clinton Center Dr
Clinton, MS 39056-5627

Mailing address

104 Clinton Center Dr
Clinton, MS 39056-5627
Phone (601) 924-0770

National Provider Directory

National Provider Directory

Locations

104 Clinton Center Dr
Clinton, MS 39056
Phone (601) 924-0770

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1205798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205798400000",
    "number": "1851562722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 CLINTON CENTER DR",
            "city": "CLINTON",
            "state": "MS",
            "postal_code": "390565627",
            "telephone_number": "601-924-0770",
            "fax_number": "601-924-2523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 CLINTON CENTER DR",
            "city": "CLINTON",
            "state": "MS",
            "postal_code": "390565627",
            "telephone_number": "601-924-0770",
            "fax_number": "601-924-2523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RYAN TRACY, DMD, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-18",
        "last_updated": "2008-03-18",
        "status": "A",
        "authorized_official_last_name": "TRACY",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "RYAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-924-0770",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "MS",
            "license": "3072-98",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2008; 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.