Provider Demographics
NPI:1255475117
Name:SHIPP, RYAN C (DMD, MS)
Entity Type:Individual
Prefix:DR
First Name:RYAN
Middle Name:C
Last Name:SHIPP
Suffix:
Gender:M
Credentials:DMD, MS
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Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9053 S PECOS RD STE 3000
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-7179
Mailing Address - Country:US
Mailing Address - Phone:702-798-0911
Mailing Address - Fax:702-798-4723
Practice Address - Street 1:9053 S PECOS RD STE 3000
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89074-7179
Practice Address - Country:US
Practice Address - Phone:702-798-0911
Practice Address - Fax:702-798-4723
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-16
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NV54911223E0200X
IDD-4207-EN1223E0200X
NVS7-551223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics