DR. RYAN JAMES DAVIS (NPI# 1396916649) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396916649 |
| Entity Type | Individual |
| Full Name | DR. RYAN JAMES DAVIS |
| Credential | DMD, MS |
| Practice Address |
1717 W Candletree Dr Ste A Peoria IL 61614-1592 |
| Practice Telephone | 3093608502 |
| Mailing Telephone | 3093608502 |
| Enumeration Date | 2008-03-14 |
| Last Update Date | 2012-10-17 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 122300000X | Dentist | 019.027.427 | IL | Dental Providers |
| Y | 1223P0300X |
Dentist Specialization: Periodontics |
021.002357 | IL | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902419237 | Ryan Davis | Physical Therapist | 1701 S Waverly Rd Ste 101, Lansing, MI 48917-4300 | 2020-08-26 |
| 1801200498 | Ryan Davis | Case Manager/Care Coordinator | 2875 James Blvd, Poplar Bluff, MO 63901-3395 | 2014-06-11 |
| 1225399553 | Ryan Davis | Specialist/Technologist | 1709 Campus Dr, Vestal, NY 13850-4040 | 2012-06-04 |
| 1710120621 | Ryan Matthew Davis | Dentist | 2d Denbn/ndc 2dmlg, Pcs Box 20130, Camp Lejeune, NC 28542-0130 | 2009-04-08 |
| 1841437647 | Ryan T Davis | Specialist/Technologist | 103 E Lincoln St, Unit G, Normal, IL 61761-1442 | 2009-01-15 |
| 1871613364 | Ryan Kory Davis | Psychiatry & Neurology | 6 Oleary Way, 83, Boston, MA 02130-3759 | 2007-03-30 |
| 1801982988 | Ryan Davis | Dentist | 700 Belford Ave, Ste 101, Grand Junction, CO 81501 | 2006-10-05 |
| 1851408033 | Ryan James Davis | Chiropractor | 204 Nw 5th St, Grand Rapids, MN 55744-2607 | 2006-08-24 |
| 1780284570 | Ryan Davis | Dentist | 2330 S Lamar Blvd Ste 300, Austin, TX 78704-5265 | 2020-10-29 |
| 1386256238 | Ryan Clifford Davis | Pharmacist | 102 S 1st St, Jesup, GA 31545-1171 | 2020-08-21 |
| Street Address |
1717 W CANDLETREE DR STE A |
| City | PEORIA |
| State | IL |
| Zip Code | 61614-1592 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548818511 | Christine Svoboda | Social Worker | 6919 N Knoxville Ave Ste 100 and 202, Peoria, IL 61614 | 2019-09-03 |
| 1639649007 | Kathy Karouzos Counseling, LLC | Clinic/Center | 330 W. Ivy Ln., Peoria, IL 61614 | 2018-11-28 |
| 1205312790 | Kathleen Marie Hendricks | Nurse Practitioner | 2809 W Willow Knolls Dr, Peoria, IL 61614 | 2018-07-17 |
| 1629563937 | Mary Elizabeth Cunningham | Counselor | 6219 N. Eldorado Dr., Peoria, IL 61614 | 2018-06-28 |
| 1861937955 | Angela Gilles | Social Worker | 6919 N Knoxville Ave Ste 100, Peoria, IL 61614 | 2016-12-27 |
| 1467994897 | Melissa Saxsma | Specialist | 5009 N Executive Dr, Peoria, IL 61614 | 2016-11-16 |
| 1902258874 | Rashid Plastic Surgery, LLC | Plastic Surgery | 804 W Trailcreek Drive, Peoria, IL 61614 | 2016-07-05 |
| 1215313143 | Melissa Lynn Phelan | Nurse Practitioner | 122 E Morningside Dr, Peoria, IL 61614 | 2015-08-03 |
| 1811380165 | All Ways Caring Services, Inc. | In Home Supportive Care | 6919 N Knoxville Ave, Suite 102, Peoria, IL 61614 | 2015-03-11 |
| 1568875920 | Schuler & Arkwell Orthodontic Partnership | Dentist | 2425 Cornerstone Ct. Ste. A, Peoria, IL 61614 | 2014-06-03 |
| Find all providers in zip 61614 | ||||
| Taxonomy Code | 1223P0300X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Periodontics |
| That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780069997 | J Brent Sanders Dds PC | Dentist | 7505 W Deer Valley Rd Ste 130, Peoria, AZ 85382-2107 | 2015-07-29 |
| 1881750420 | Christopher Joseph Couri | Dentist | 1101 N North Street, Peoria, IL 61606-1918 | 2006-12-28 |
| 1689744484 | John R Francis | Dentist | 8671 W Union Hills Dr Ste 501, Peoria, AZ 85382-7005 | 2006-11-09 |
| 1538173216 | William E. Cusack | Dentist | 5013 N University St, Ste. 2, Peoria, IL 61614-4792 | 2006-07-28 |
| 1194745026 | Aziz Ali Bohra | Dentist | 13360 N 94th Dr, Suite C, Peoria, AZ 85381-4837 | 2006-07-21 |
| 1972128858 | Burgardt and Diaz Dental Group, Pllc | Dentist | 13260 N 94th Dr Ste 410, Peoria, AZ 85381-4241 | 2020-06-16 |
| 1720282338 | Stephen Alan Folson | Dentist | 13260 N 94th Dr, Suite 410, Peoria, AZ 85381-4828 | 2007-06-14 |
| 1902019607 | Jeffrey Brent Sanders | Dentist | 7505 W. Deer Valley Rd., Suite 130, Peoria, AZ 85382 | 2007-05-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891309399 | Dominik Dubravec Dds Mmsc PC | Dentist | 555 W Court St Ste 202, Kankakee, IL 60901-3674 | 2020-09-02 |
| 1598374167 | Dubravec Periodontal Specialists PC | Dentist | 20635 Abbey Woods Ct N Ste 203, Frankfort, IL 60423-3186 | 2020-07-29 |
| 1972145183 | Dental Dream Team Associates LLC Yetta Mccullom Sole Mbr | Dentist | 820 E 87th St Ste 201, Chicago, IL 60619-6256 | 2019-10-09 |
| 1083192389 | Amirreza Ghassemi | Dentist | 2800 College Ave Bldg 285, Alton, IL 62002-4742 | 2018-07-30 |
| 1508355678 | Periodontal Associates, LLP | Dentist | 845 N Michigan Ave Ste 940w, Chicago, IL 60611-2216 | 2018-05-04 |
| 1043750714 | Bloomingdale Dental Rez, PC | Dentist | 1 Tiffany Pt Ste 209, Bloomingdale, IL 60108-2916 | 2017-03-01 |
| 1114398831 | Dubravec Periodontal Associates, PC | Dentist | 1900 Spring Rd, Suite 205, Oak Brook, IL 60523-1447 | 2015-10-08 |
| 1689059297 | Amer Atassi | Dentist | 6224 S Elm St, Burr Ridge, IL 60527-5228 | 2015-07-24 |
| 1013304724 | Elliott T. Deweese | Dentist | 7447 W Talcott Ave., Suite 227, Chicago, IL 60631 | 2015-04-20 |
| 1215345939 | Mark Kolozenski, Dds, Ms, PC | Dentist | 10083 W Lincoln Hwy, Frankfort, IL 60423-1272 | 2014-07-25 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.