DR. RYAN HASTIIN WILSON (NPI# 1780811984) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780811984 |
| Entity Type | Individual |
| Full Name | DR. RYAN HASTIIN WILSON |
| Credential | DDS |
| Practice Address |
6810 Menaul Blvd Ne Ste B Albuquerque NM 87110 |
| Mailing Address |
101 Los Miradores Dr Ne Rio Rancho NM 87124-4279 |
| Practice Telephone | 5058721100 |
| Mailing Telephone | 5054278577 |
| Enumeration Date | 2009-06-15 |
| Last Update Date | 2019-07-06 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223E0200X |
Dentist Specialization: Endodontics |
DD3162 | NM | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | ANOTHER BUSINESS | 455369173 | 01 |
| NM | ANOTHER BUSINESS | 270372394 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 101 Los Miradores Dr Ne, Rio Rancho, NM 871244279 | 5054278577 | |
| 6810 Menaul Blvd Ne Ste B, Albuquerque, NM 87110 | 5058721100 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831796093 | Ryan Alan Wilson | Physical Therapist | 1020 Queensgate Dr Ste B, Richland, WA 99352-9123 | 2020-10-01 |
| 1346889359 | Ryan Wilson | Occupational Therapist | 8320 5th Ave Ne Ste A, Seattle, WA 98115-4174 | 2019-12-23 |
| 1326530007 | Ryan Wilson | Social Worker | 1900 E Northern Pkwy Ste 300, Baltimore, MD 21239-2113 | 2018-05-30 |
| 1679920482 | Ryan Scott Wilson | Dentist | 3706 Davis Stuart Rd, Lewisburg, WV 24901-9463 | 2016-05-22 |
| 1174908651 | Ryan Wilson | Social Worker | 1905 W 8th St, #209, Loveland, CO 80537-5224 | 2015-07-24 |
| 1407832454 | Ryan J Wilson | Optometrist | 422 South State Street, Geneseo, IL 61254-1536 | 2005-12-21 |
| 1922094184 | Ryan D Wilson | Emergency Medicine | 800 24th Ave, Norman, OK 73069 | 2005-09-23 |
| 1679171342 | Ryan Zachary Wilson | Physical Therapist | 342 Fifth Ave, Pelham, NY 10803-1204 | 2020-10-14 |
| 1396343463 | Ryan Wilson | Case Manager/Care Coordinator | 1111 W Mockingbird Ln Ste 1030, Dallas, TX 75247-5028 | 2020-10-12 |
| 1124657556 | Ryan Wilson | Nurse Practitioner | 2761 Agnes Ln, Myrtle Beach, SC 29577-2029 | 2020-04-07 |
| Street Address |
6810 MENAUL BLVD NE STE B |
| City | ALBUQUERQUE |
| State | NM |
| Zip Code | 87110 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073042271 | Nicole Rae Ainsworth | Dentist | 6810 Menaul Blvd Ne Ste B, Albuquerque, NM 87110-3725 | 2017-06-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215550199 | Sabrina Jennifer Lujan | Counselor | 8401 Constitution Ave Nw, Albuquerque, NM 87110 | 2020-05-26 |
| 1649829318 | Robert D. Oliver | Technician | 2705 Texas Street Ne, Albuquerque, NM 87110 | 2019-09-05 |
| 1033770904 | Life Re-created LLC | Counselor | 3939 San Pedro Dr. Ne, Bld C, Ste 8, Albuquerque, NM 87110 | 2019-06-21 |
| 1497319693 | Clear Choice Vision Care, LLC | Optometrist | 6600 Menaul Blve Ne, Suite M5a, Albuquerque, NM 87110 | 2019-04-24 |
| 1790257558 | Diana M Nicolas | Dietitian, Registered | 8300 Constitution Ave Ne Bld D, Albuquerque, NM 87110 | 2018-12-18 |
| 1689168403 | Robin N Hermes, Md, PC | Anesthesiology | 2440 Lousiana Blvd. Ne, Ste 580, Albuquerque, NM 87110 | 2018-06-15 |
| 1710481726 | Desert Mountain Eyecare LLC | Optometrist | 5504 Menaul Blvd Ne Ste Aandb, Albuquerque, NM 87110 | 2018-03-23 |
| 1659873131 | Amanda Lacasse | Registered Nurse | 6400 Uptown Blvd Ne Suite 360 West, Albuquerque, NM 87110 | 2018-03-01 |
| 1518485655 | Danielle Liegh Wyne | Counselor | 6121 Indian School Rd, Suite 141, Albuquerque, NM 87110 | 2017-09-08 |
| 1265957237 | Myrrhine Faller | Speech-Language Pathologist | 6020 Constitution Ave. Ne, Suite 4, Albuquerque, NM 87110 | 2017-08-10 |
| Find all providers in zip 87110 | ||||
| Taxonomy Code | 1223E0200X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Endodontics |
| The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669024840 | Robert Hochberg, Dds, LLC | Dentist | 7520 Montgomery Blvd Ne Ste B, Building C, Albuquerque, NM 87109-1521 | 2019-07-09 |
| 1922586262 | Clark Endodontics LLC | Dentist | 7520 Montgomery Blvd Ne Bldg E1, Albuquerque, NM 87109 | 2018-07-30 |
| 1003220203 | Shane Thomas Clark | Dentist | 2800 Coors Blvd Nw, Albuquerque, NM 87120-1204 | 2014-06-16 |
| 1356508931 | David Lloyd Hadley | Dentist | 10409 Montgomery Pkwy Ne Ste 100, Albuquerque, NM 87111-3862 | 2008-05-21 |
| 1760671705 | New Mexico Endodontic Specialists, PC | Dentist | 10151 Montgomery Blvd Ne Ste 2b, Albuquerque, NM 87111-3664 | 2007-10-16 |
| 1891989158 | Jeffrey Michael Clark | Dentist | 10429 Lagrima De Oro Rd Ne, Albuquerque, NM 87111 | 2007-08-30 |
| 1134334907 | Colin Simeon Shaw | Dentist | 4620 Jefferson Ln Ne Ste C, Albuquerque, NM 87109-2120 | 2007-05-14 |
| 1063493427 | Advanced Endodontics | Dentist | 7520 Montgomery Blvd, E1, Albuquerque, NM 87109 | 2005-11-10 |
| 1063940237 | John Steffensen | Dentist | 2800 Coors Blvd Nw Ste A, Albuquerque, NM 87120-1204 | 2017-05-31 |
| 1568854339 | Papworth Endodontics | Dentist | 10151 Montgomery Blvd Ne, Suite 1-c, Albuquerque, NM 87111-3670 | 2015-03-03 |
| Find all providers in ALBUQUERQUE | ||||
| City | ALBUQUERQUE |
| Zip Code | 87110 |
Please comment or provide details below to improve the information on DR. RYAN HASTIIN WILSON.
| 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.