Healthcare Provider Details

I. General information

NPI: 1457541997
Provider Name (Legal Business Name): RYAN BYBEE D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/31/2007
Last Update Date: 07/21/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 W SUNSET RD SUITE B
HENDERSON NV
89014-2654
US

IV. Provider business mailing address

1600 W SUNSET RD SUITE B
HENDERSON NV
89014-2654
US

V. Phone/Fax

Practice location:
  • Phone: 702-733-8341
  • Fax: 702-733-2115
Mailing address:
  • Phone: 702-733-8341
  • Fax: 702-733-2115

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number5900
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: