Dr. Matthew Ryan Dental Practice Corporation

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

DR. MATTHEW RYAN DENTAL PRACTICE CORPORATION

Practice address

4350 Marconi Ave Ste 100
Sacramento, CA 95821-4379

Phone

(916) 486-8255

Fax

(916) 486-8266

NPI assigned

Mar 26, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Matthew D Ryan, DDS

Title

Owner

Phone

(916) 486-8255

Specialties & licenses 1

Addresses

Other names 1

• Dr. Matthew Ryan Doing business as

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

{
    "created_epoch": "1585180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1585180800000",
    "number": "1962039057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4350 MARCONI AVE STE 100",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958214379",
            "telephone_number": "916-486-8255",
            "fax_number": "916-486-8266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4350 MARCONI AVE STE 100",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958214379",
            "telephone_number": "916-486-8255",
            "fax_number": "916-486-8266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. MATTHEW RYAN DENTAL PRACTICE CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-26",
        "last_updated": "2020-03-26",
        "certification_date": "2020-03-26",
        "status": "A",
        "authorized_official_last_name": "RYAN",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "916-486-8255",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dr. Matthew Ryan",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Dental Clinic/Center in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Dental Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2020; 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.