Individual provider Active NPI

Ross Ryan, D.D.S.

  • Dentist
  • Bloomfield Hills, MI
National Provider Identifier
1992068977
Registry record updated Sep 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019.028923 Issued in IL
Practice address
50 W Big Beaver Rd Ste 200
Bloomfield Hills, MI 48304-3912
Phone
(248) 647-7930
NPI assigned
Jun 24, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019.028923 IL Primary

Addresses

Primary practice location

50 W Big Beaver Rd Ste 200
Bloomfield Hills, MI 48304-3912

Mailing address

50 W Big Beaver Rd Ste 200
Bloomfield Hills, MI 48304-3912
Phone (248) 647-7930

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161013000264 MI Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 4183844269

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019.028923ILMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Endodontic Associates of Michigan PLLC CurrentSince Mar 11, 2025 Accepting new patients
Endodontic Associates of Michigan PLLC PastSince Sep 28, 2021 Accepting new patients
Absolute Dental PC Past Accepting new patients

Locations

50 W Big Beaver Rd
Ste 200
Bloomfield Hills, MI 48304
Phone (248) 647-7930

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1340496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632096000000",
    "number": "1992068977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 W BIG BEAVER RD STE 200",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483043912",
            "telephone_number": "248-647-7930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 W BIG BEAVER RD STE 200",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483043912",
            "telephone_number": "248-647-7930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYAN",
        "first_name": "ROSS",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-06-24",
        "last_updated": "2021-09-20",
        "certification_date": "2021-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019.028923",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomfield Hills, MI

Sources for this page

Verify at the official NPI Registry.