Dr. Randy Jack Ryan , DDS
Dentist - General Practice • Tishomingo, OK
Notice of NPI Deactivation & Inactive Practice Status
According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Randy Ryan has officially deactivated this NPI record and ceased active healthcare practice.
Professional Overview & Biography Verified Profile Summary
Dr. Randy Ryan, DDS was a registered Dentist - General Practice practicing in Tishomingo, OK. Throughout an active medical career spanning 12 years, Dr. Ryan provided care at the practice location at 212 W MAIN ST until profile deactivation on 2019-06-17.
Practice Location & Contact Primary Location
212 W Main St
Tishomingo, OK 734601725
Specialty Benchmarks & Practice Insights
Comparative analytics for Dentist - General Practice in Tishomingo, OK
Practicing in Tishomingo, OK (1496 Statewide)
In-Person Office Visits Only
Under CMS Medicare Fee Schedule vs Standard Submitted Charges
Medical Specialties & State Licenses
NUCC Taxonomy Code: 1223G0001X
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
Career & Practice History Timeline
Chronological log of verified NPI updates, location relocations, credentials, and registry changes
Record deactivated on June 17, 2019
NPI status registered as active in NPPES database
Registered at 212 W MAIN ST, TISHOMINGO, OK 734601725 (Tel: 5803719559)
Registered at PO BOX 310, 212 W. MAIN, TISHOMINGO, OK 734600310 (Tel: 5803719559)
Recorded as RANDY RYAN, D.D.S.
Dentist (License #4427 in OK)
First registered as active Individual Practitioner in NPPES Database.
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NPI Administrative Meta
Mailing Address
Po Box 310, 212 W. Main
Tishomingo, OK 734600310
Phone: 5803719559
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