Ryan T Anderson DDC PC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

00202659 Issued in CO

Legal business name

RYAN T ANDERSON DDC PC

Practice address

13 E 4TH St.
La Junta, CO 81050

Phone

(719) 384-9442

NPI assigned

Nov 5, 2015

Last updated

Feb 15, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ryan Anderson, D.D.SNPI 1083086524

Title

General Dentist

Phone

(719) 384-9442

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ryan Taylor Anderson, D.D.S

  • General Practice Dentistry
  • La Junta, CO
  • NPI 1083086524
  NPD (past) Authorized official
• Rosa Linda Lacy, DDS

  • General Practice Dentistry
  • La Junta, CO
  • NPI 1164440491
  NPD (past)

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

{
    "created_epoch": "1446681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1550188800000",
    "number": "1952774465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13 E 4TH ST",
            "city": "LA JUNTA",
            "state": "CO",
            "postal_code": "810503601",
            "telephone_number": "719-384-9442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13 E 4TH ST.",
            "city": "LA JUNTA",
            "state": "CO",
            "postal_code": "81050",
            "telephone_number": "719-384-9442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RYAN T ANDERSON DDC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-05",
        "last_updated": "2019-02-15",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "GENERAL DENTIST",
        "authorized_official_telephone_number": "719-384-9442",
        "authorized_official_credential": "D.D.S"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "CO",
            "license": "00202659",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02061620",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melissa W Root, DNP-ED, MSN, RN
• Amy Lyn Rosengrants-Smith, M.A.
• Ashley Ross, B.S.
• Robin Charles Runk, A.A.
• Anne M Russell, B.A.
• Ryon Medical & Associates, LLC
• Safe Space Child and Family Therapy LLC
• Steven Sanchez
• Sangre de Cristo Community Care (Country Plains Home Health)
• Sangre de Cristo Community Care Hospice East (Sangre de Cristo Community Care)

• Dental Clinic/Center in La Junta, CO
• Providers in La Junta, CO by specialty
• Dental Clinic/Center in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2019; 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.