DR. RYAN LEE RADER (NPI# 1245451749) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245451749 |
| Entity Type | Individual |
| Full Name | DR. RYAN LEE RADER |
| Credential | D.M.D |
| Practice Address |
11709 Old Ballas Rd Suite 206 Creve Coeur MO 63141-7029 |
| Mailing Address |
1341 Robertridge Dr Saint Charles MO 63304-3420 |
| Practice Telephone | 3145673760 |
| Mailing Telephone | 6185585272 |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 1223P0300X |
Dentist Specialization: Periodontics |
2006016236 | MO | Dental Providers |
| X | 122300000X | Dentist | IL | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407389455 | Ryan Rader | Internal Medicine | 40 Duke Medicine Cir # 1e, Durham, NC 27710-4000 | 2017-04-06 |
| Street Address |
11709 OLD BALLAS RD SUITE 206 |
| City | CREVE COEUR |
| State | MO |
| Zip Code | 63141-7029 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720512551 | Brittany Ryan Staples | Podiatrist | 11709 Old Ballas Rd, Ste 201, Creve Coeur, MO 63141-7029 | 2017-04-18 |
| 1952754772 | Sameera Riaz-malik | Social Worker | 11709 Old Ballas Rd, Suite 205, Creve Coeur, MO 63141-7029 | 2016-07-16 |
| 1255759197 | Ryan Rader Enterprises Dmd LLC | Dentist | 11709 Old Ballas Rd, Ste 206, Creve Coeur, MO 63141-7029 | 2014-03-28 |
| 1790124923 | Brian Douglass Bourbon | Specialist | 11709 Old Ballas Rd, Suite 201, Creve Coeur, MO 63141-7029 | 2013-06-20 |
| 1174812358 | Jared Visser | Podiatrist | 11709 Old Ballas Rd, Suite 201, Creve Coeur, MO 63141-7029 | 2011-03-29 |
| 1366697906 | Shirley Mae Catoire Visser | Podiatrist | 11709 Old Ballas Rd, Suite 201, Creve Coeur, MO 63141-7029 | 2008-11-24 |
| 1174799415 | Creve Coeur Periodontics, Inc. | Dentist | 11709 Old Ballas Rd, Suite 206, Creve Coeur, MO 63141-7029 | 2008-05-06 |
| 1760697965 | Douglas John Fox | Dentist | 11709 Old Ballas Rd, Creve Coeur, MO 63141-7029 | 2007-05-11 |
| 1295956167 | Milton A Rubin | Psychologist | 11709 Old Ballas Rd, Suite 105, Creve Coeur, MO 63141 | 2007-05-01 |
| 1609906577 | Mid-west Podiatry and Associates, LLC | Podiatrist | 11709 Old Ballas Rd, Suite 201, Creve Coeur, MO 63141-7029 | 2007-03-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679102842 | Noor Ramadan | Pharmacist | 628 North New Ballad Road, Suite A, Creve Coeur, MO 63141 | 2020-04-08 |
| 1497381206 | Washington University | Durable Medical Equipment & Medical Supplies | 1044 North Mason Road, Suite 110/210, St. Louis, MO 63141 | 2020-03-13 |
| 1154956498 | Ashleigh Clendenny | Physician Assistant | Mercy Hospital St. Louis, 615 S New Ballas Rd, St. Louis, MO 63141 | 2020-03-06 |
| 1801429410 | Emili Lou Haley | Registered Nurse | 650 Maryville Drive, St Louis, MO 63141 | 2020-02-21 |
| 1629553110 | Rebecca Kathleen Pike | Social Worker | West County Psychological Associates, 12125 Woodcrest Executive Drive #110, St. Louis, MO 63141 | 2018-10-01 |
| 1649756099 | River City Sedation Associates, LLC | Nurse Anesthetist, Certified Registered | 12855 N 40 Dr Ste 150, Saint Louis, MO 63141 | 2018-07-18 |
| 1205333952 | Ear Care and Hearing of St. Louis | Hearing Aid Equipment | 11630 Studt Ave Ste 210, Creve Coeur, MO 63141 | 2018-04-10 |
| 1659897486 | Erin Goodman | Physical Therapist | 10560 Old Olive St. Rd, Suite 100, Creve Coeur, MO 63141 | 2017-08-14 |
| 1093230450 | Center for Urologic Surgery LLC | Clinic/Center | 12855 N 40 Dr Ste 100, Saint Louis, MO 63141 | 2017-08-07 |
| 1871016105 | Jacob Farley Tanner | Specialist/Technologist | 1054 Town and Four Parkway Dr, Creve Coeur, MO 63141 | 2017-07-19 |
| Find all providers in zip 63141 | ||||
| Taxonomy Code | 1223P0300X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Periodontics |
| That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255759197 | Ryan Rader Enterprises Dmd LLC | Dentist | 11709 Old Ballas Rd, Ste 206, Creve Coeur, MO 63141-7029 | 2014-03-28 |
| 1174799415 | Creve Coeur Periodontics, Inc. | Dentist | 11709 Old Ballas Rd, Suite 206, Creve Coeur, MO 63141-7029 | 2008-05-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609233089 | Seth Rush, D.d.s., M.s., L.L.C. | Dentist | 9233 Ward Pkwy Ste 330, Kansas City, MO 64114-3310 | 2016-01-15 |
| 1861877227 | Pierluigi Balice | Dentist | 650 E 25th St # 277, Kansas City, MO 64108-2716 | 2015-07-28 |
| 1881960102 | Sara Layne Walls | Dentist | 833 Sw Lemans Ln Ste 234, Lees Summit, MO 64082-4618 | 2012-03-30 |
| 1376814723 | Nabil Beaini | Dentist | 201 W Broadway Ste 5a, Columbia, MO 65203-3842 | 2012-01-17 |
| 1639494214 | Daniel J Thomas, Dds Periodontal Specialists, PC | Dentist | 3355 Ne Ralph Powell Rd, Lees Summit, MO 64064-2368 | 2010-04-07 |
| 1679804157 | John C Hoppin, Dds., PC | Dentist | 1 Westbury Dr Ste 300, Saint Charles, MO 63301-2560 | 2010-01-22 |
| 1750537320 | Robert R. Schlueter Dmd PC | Dentist | 9914 Kennerly Rd., St. Louis, MO 63128-2704 | 2008-08-14 |
| 1972785533 | Amy Leigh Gillihan | Dentist | 3151 S 291 Hwy, Suite B, Independence, MO 64057-2602 | 2007-12-05 |
| 1750590139 | Humaira Y Habib | Dentist | 420 S Pearl Ave, Ste 4, Joplin, MO 64801-2541 | 2007-05-22 |
| 1225240856 | Videsh Damodar Deshmukh | Dentist | 300 Chesterfield Ctr, Siute # 160, Chesterfield, MO 63017-4867 | 2007-05-04 |
| Find all providers with the same taxonomy | ||||
| City | CREVE COEUR |
| Zip Code | 63141 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.