MEDICARE: DR. MATTHEW THOMAS RYKER D.D.S., M.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	30-02-1661	OH
2	1223P0300X	Periodontics	30.021661	OH
3	1223P0300X	Periodontics	36020	TX

General Provider Information

NPI Number	:	1326036237
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MATTHEW THOMAS RYKER D.D.S., M.S.

Provider Business Mailing Address
First Line	:	5 GREENS WHISPER
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78216-7882
Country	:	US
Telephone Number	:	210-382-9859
Fax Number	:

Provider Business Practice Location Address
First Line	:	21477 SH-46
Second Line	:
City	:	SPRING BRANCH
State	:	TX
Zip	:	78070
Country	:	US
Telephone Number	:	830-438-5174
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/13/2005
Last Update Date	:	12/27/2022

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