1679705271 NPI number — DR. RYAN JOSEPH HANKS D.D.S.

Table of content: DR. RYAN JOSEPH HANKS D.D.S. (NPI 1679705271)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1679705271 NPI number — DR. RYAN JOSEPH HANKS D.D.S.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HANKS
Provider First Name:
RYAN
Provider Middle Name:
JOSEPH
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.D.S.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1679705271
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/27/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8012 112TH STREET CT E
Provider Second Line Business Mailing Address:
160
Provider Business Mailing Address City Name:
PUYALLUP
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98373-7856
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
253-840-0789
Provider Business Mailing Address Fax Number:
253-841-6832

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8012 112TH STREET CT E
Provider Second Line Business Practice Location Address:
160
Provider Business Practice Location Address City Name:
PUYALLUP
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98373-7856
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
253-840-0789
Provider Business Practice Location Address Fax Number:
253-841-6832
Provider Enumeration Date:
08/14/2009

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , with the licence number:  DENT.DE.60106572 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)