Provider Demographics
NPI:1386860104
Name:ENGELBERG, RYAN HOWARD (DDS)
Entity Type:Individual
Prefix:DR
First Name:RYAN
Middle Name:HOWARD
Last Name:ENGELBERG
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 1:10802 N 71ST PL
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-5204
Mailing Address - Country:US
Mailing Address - Phone:480-991-1144
Mailing Address - Fax:480-998-1565
Practice Address - Street 1:10802 N 71ST PL
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-5204
Practice Address - Country:US
Practice Address - Phone:480-991-1144
Practice Address - Fax:480-998-1565
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2013-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD47061223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics