Ryan Hartley, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

2901602252 Issued in MI

Practice address

1632 Leonard St NW
Grand Rapids, MI 49504-3950

Phone

(616) 460-3838

NPI assigned

Mar 10, 2023

Last updated

Jul 1, 2024By 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 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Ryan Hartley DMD PLLC

  dba Kentwood Family Dentistry

  • Dental Clinic/Center
  • Kentwood, MI
  • NPI 1497592414
  NPD Authorized official

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

{
    "created_epoch": "1678406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719792000000",
    "number": "1932800661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "954 52ND ST SE",
            "city": "KENTWOOD",
            "state": "MI",
            "postal_code": "495086004",
            "telephone_number": "616-724-1780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1632 LEONARD ST NW",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495043950",
            "telephone_number": "616-460-3838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARTLEY",
        "first_name": "RYAN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-10",
        "last_updated": "2024-07-01",
        "certification_date": "2024-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901602252",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaitlyn Hartl
• James Hartlein
• Zachary Hartley-Blossom, MD
• Allison Hartley
• Philip Hartley
• Anthony Hartman
• Kate Hartman, PA-C
• John Hartmann, MD
• Nicholas L Hartog, M.D.
• Molly Elizabth Keller Harton, PA-C

• Dentist in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Dentist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2024; 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.