Healthcare Provider Details

I. General information

NPI: 1083141469
Provider Name (Legal Business Name): RYAN GERMANN DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/17/2017
Last Update Date: 09/03/2020
Certification Date: 09/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

850 IVES DAIRY RD STE T6
NORTH MIAMI BEACH FL
33179-2412
US

IV. Provider business mailing address

1131 NW 108TH AVE
PLANTATION FL
33322-7822
US

V. Phone/Fax

Practice location:
  • Phone: 305-654-9399
  • Fax:
Mailing address:
  • Phone: 412-523-5020
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License NumberDN25380
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: