Provider Demographics
NPI:1144744533
Name:TUINSTRA, RYAN M (DDS)
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:M
Last Name:TUINSTRA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2912 N CREEKSIDE DR
Mailing Address - Street 2:
Mailing Address - City:FLAGSTAFF
Mailing Address - State:AZ
Mailing Address - Zip Code:86001-3805
Mailing Address - Country:US
Mailing Address - Phone:480-241-9742
Mailing Address - Fax:
Practice Address - Street 1:750 N KENDRICK ST STE 100
Practice Address - Street 2:
Practice Address - City:FLAGSTAFF
Practice Address - State:AZ
Practice Address - Zip Code:86001-3067
Practice Address - Country:US
Practice Address - Phone:928-774-2500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-28
Last Update Date:2017-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD009814122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist