Active NPI
Kasey Merritt Ryan, DDS, MSD
- Pediatric Dentistry
- Muncie, IN
National Provider Identifier
1972169704
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 12013133A
- Practice address
- 3905 N Wheeling Ave
Muncie, IN 47304-1769 - Phone
- (765) 326-4389
- NPI assigned
- May 16, 2019
- 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 |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 12013133A | IN | Primary |
Addresses
Primary practice location
3905 N Wheeling Ave
Muncie, IN 47304-1769
Mailing address
10696 Sunbeam Cir
Fishers, IN 46038-1905
Phone (317) 828-3415
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190604003274 | IN | Order and Referring Only - Dentist | 6305179409 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12013133A | IN | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1557964800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1627776000000",
"number": "1972169704",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10696 SUNBEAM CIR",
"city": "FISHERS",
"state": "IN",
"postal_code": "460381905",
"telephone_number": "317-828-3415"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3905 N WHEELING AVE",
"city": "MUNCIE",
"state": "IN",
"postal_code": "473041769",
"telephone_number": "765-326-4389"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RYAN",
"first_name": "KASEY",
"middle_name": "MERRITT",
"name_prefix": "Dr.",
"credential": "DDS, MSD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-05-16",
"last_updated": "2021-08-01",
"certification_date": "2021-03-30",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "IN",
"license": "12013133A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Muncie, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.