Provider Demographics
NPI:1437815057
Name:RYAN J. FAIT, DDS, INC.
Entity Type:Organization
Organization Name:RYAN J. FAIT, DDS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:FAIT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:562-982-1552
Mailing Address - Street 1:2700 N BELLFLOWER BLVD STE 206
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90815-1144
Mailing Address - Country:US
Mailing Address - Phone:562-982-1552
Mailing Address - Fax:
Practice Address - Street 1:2700 N BELLFLOWER BLVD STE 206
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90815-1144
Practice Address - Country:US
Practice Address - Phone:562-982-1552
Practice Address - Fax:562-425-3412
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-09
Last Update Date:2021-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty