Active NPI
Ellen Ryan, RDH
- Dental Hygienist
- Beaver Dam, WI
National Provider Identifier
1952852683
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 6762-16
- Practice address
- 207 S University Ave
Beaver Dam, WI 53916-2450 - Phone
- (800) 942-5330
- Fax
- (920) 787-4737
- NPI assigned
- Oct 18, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | 6762-16 | WI | Primary |
Addresses
Primary practice location
207 S University Ave
Beaver Dam, WI 53916-2450
Mailing address
207 S University Ave
Beaver Dam, WI 53916-2450
Phone (800) 942-5330
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
| License | State | Type | Specialty |
|---|---|---|---|
| 6762-16 | WI | MD | Dental Hygienist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| La Clinica de Los Campesinos, Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
-
dba Noble Community Clinics
- Federally Qualified Health Center (FQHC)
- Stevens Point, WI
- NPI 1790786929
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1476748800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1476748800000",
"number": "1952852683",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "207 S UNIVERSITY AVE",
"city": "BEAVER DAM",
"state": "WI",
"postal_code": "539162450",
"telephone_number": "800-942-5330",
"fax_number": "920-787-4737"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "207 S UNIVERSITY AVE",
"city": "BEAVER DAM",
"state": "WI",
"postal_code": "539162450",
"telephone_number": "800-942-5330",
"fax_number": "920-787-4737"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RYAN",
"first_name": "ELLEN",
"credential": "RDH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-10-18",
"last_updated": "2016-10-18",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "WI",
"license": "6762-16",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Beaver Dam, WI
- Raquel Rodriguez-Guzman, PHARMD
- Misty M Romero Rivera, APNP
- Natalie Ross, DNP, FNP-BC, RN
- Diane Marie Rundle, WHNP
- RWH Investments LLC (Home Instead Senior Care)
- Hunter Olivia Ryan, NP
- Katey Ryan, SACIT
- Kaitlyn Rose Rychlowski, APNP, PMHNP-BC
- Safe & Sound Anesthesia Services, Inc
- Ayaz M Samadani, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.