Ryan Jolley, DMD

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

LL-385-14 Issued in NV

Practice address

1001 Shadow LN
Las Vegas, NV 89106-4124

Phone

(702) 774-2400

NPI assigned

Dec 2, 2014

Last updated

Dec 2, 2014By the provider in NPPES

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

Enrolled in CA

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

Medicare enrollment (NPD)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Shadow Creek Children's Dentistry and Orthodontics General Partnership

  dba Shadow Creek Children's Dentistry and Orthodontics

  • Pediatric Dentistry
  • North Las Vegas, NV
  • NPI 1063309755

  Orthodontics and Dentofacial Orthopedics

  NPD Authorized official

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

{
    "created_epoch": "1417478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1417478400000",
    "number": "1912304254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10116 OCICAT AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891665254",
            "telephone_number": "702-574-4768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 SHADOW LN",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891064124",
            "telephone_number": "702-774-2400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOLLEY",
        "first_name": "RYAN",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-12-02",
        "last_updated": "2014-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NV",
            "license": "LL-385-14",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joint Replacement Cin of Las Vegas LLC
• Joint Technology Inc
• Brandi Paulette Jointer, LCPC
• Jasmine Jointer
• Jessica L Jolley, CHW
• Lora Jolliff
• Georgiana Jolly
• Tiffany M Jolly, LMSW
• Isistania Jomarron
• Jon a Failla Aprn PLLC

• Orthodontics and Dentofacial Orthopedics Dentistry in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.