Healthcare Provider Details

I. General information

NPI: 1477864171
Provider Name (Legal Business Name): KARI ANN RYAN D.M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/28/2010
Last Update Date: 10/29/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

815 LOWCOUNTRY BLVD
MOUNT PLEASANT SC
29464-3024
US

IV. Provider business mailing address

815 LOWCOUNTRY BLVD
MOUNT PLEASANT SC
29464-3024
US

V. Phone/Fax

Practice location:
  • Phone: 843-881-1638
  • Fax: 843-881-4199
Mailing address:
  • Phone: 843-881-1638
  • Fax: 843-881-4199

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number6906
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDGD.6906 GD
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: