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Deactivated NPI 1356499859 Deactivated / Inactive NPI Male Practitioner

Dr. Randy Jack Ryan , DDS

Dentist - General Practice • Tishomingo, OK

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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.

Registration / Start Date January 08, 2007
NPI Deactivation Date June 17, 2019
Total Practice Duration ~12 Years of Practice (2007 – 2019)

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

Practice Address

212 W Main St

Tishomingo, OK 734601725

Telephone 5803719559
Fax 5803713622

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Tishomingo, OK

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 17.8 Yrs
Regional Practice Density
2 Specialists

Practicing in Tishomingo, OK (1496 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License OK 4427

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

7 Historical Events
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NPI Profile Deactivated June 17, 2019

Record deactivated on June 17, 2019

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 212 W MAIN ST, TISHOMINGO, OK 734601725 (Tel: 5803719559)

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Updated Business Mailing Address July 08, 2007

Registered at PO BOX 310, 212 W. MAIN, TISHOMINGO, OK 734600310 (Tel: 5803719559)

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Provider Name / Credentials Updated July 08, 2007

Recorded as RANDY RYAN, D.D.S.

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Dentist (License #4427 in OK)

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Initial NPI Registration & Enumeration January 08, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1356499859
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: January 08, 2007
Last Update: July 08, 2007
Deactivation Date: June 17, 2019

Mailing Address

Po Box 310, 212 W. Main

Tishomingo, OK 734600310

Phone: 5803719559

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.