Healthcare Provider Details

I. General information

NPI: 1295961829
Provider Name (Legal Business Name): RYAN ROBERT FALKE DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/10/2009
Last Update Date: 04/20/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

757 W 7TH ST STE 102
RENO NV
89503-3672
US

IV. Provider business mailing address

757W 7TH ST 102
RENO NV
89503-3672
US

V. Phone/Fax

Practice location:
  • Phone: 775-284-2500
  • Fax:
Mailing address:
  • Phone: 775-329-2299
  • Fax: 775-329-2450

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number58325
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License NumberS1-136
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: