Individual provider Active NPI

Ronald Dale Risner, DDS

  • Dentist
  • Tulsa, OK
National Provider Identifier
1922116490
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
3603 Issued in OK
Practice address
5930 E 31St St
Ste 305
Tulsa, OK 74135-5111
Phone
(918) 627-1717
NPI assigned
Aug 26, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 3603 OK Primary

Addresses

Primary practice location

5930 E 31St St
Ste 305
Tulsa, OK 74135-5111

Mailing address

5930 E 31St St
Ste 305
Tulsa, OK 74135-5111
Phone (918) 627-1717

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

LicenseStateTypeSpecialty
3603OKMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1156550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1922116490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5930 E 31ST ST",
            "address_2": "STE 305",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741355111",
            "telephone_number": "918-627-1717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5930 E 31ST ST",
            "address_2": "STE 305",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741355111",
            "telephone_number": "918-627-1717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RISNER",
        "first_name": "RONALD",
        "middle_name": "DALE",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OK",
            "license": "3603",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.