Individual provider Active NPI

Ryan Scott Nygard

  • General Practice Dentistry
  • Fargo, ND
National Provider Identifier
1881075257
Registry record updated Jun 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2260 Issued in ND
Practice address
3011 25TH St S
Suite 1
Fargo, ND 58103-6162
Phone
(701) 280-0088
Fax
(701) 293-5602
NPI assigned
Jun 11, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2260 ND Primary

Addresses

Primary practice location

3011 25TH St S
Suite 1
Fargo, ND 58103-6162

Mailing address

3011 25TH St S
Suite 1
Fargo, ND 58103-6162
Phone (701) 280-0088

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND
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
I20170217001194 ND Order and Referring Only - DentistPractitioner - Dentist 1850674847

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Smile Care PastSince Sep 25, 2022 Accepting new patients
Paul a. Fredrikson, D.D.S., P.C. General Practice Past Accepting new patients

Organizations & group practices 2

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": "1433980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433980800000",
    "number": "1881075257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3011 25TH ST S",
            "address_2": "SUITE 1",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581036162",
            "telephone_number": "701-280-0088",
            "fax_number": "701-293-5602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3011 25TH ST S",
            "address_2": "SUITE 1",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581036162",
            "telephone_number": "701-280-0088",
            "fax_number": "701-293-5602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NYGARD",
        "first_name": "RYAN",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-11",
        "last_updated": "2015-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ND",
            "license": "2260",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fargo, ND

Sources for this page

Verify at the official NPI Registry.