Provider Demographics
NPI:1477864171
Name:RYAN, KARI ANN (DMD)
Entity Type:Individual
Prefix:DR
First Name:KARI
Middle Name:ANN
Last Name:RYAN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:815 LOWCOUNTRY BLVD
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-3024
Mailing Address - Country:US
Mailing Address - Phone:843-881-1638
Mailing Address - Fax:843-881-4199
Practice Address - Street 1:815 LOWCOUNTRY BLVD
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-3024
Practice Address - Country:US
Practice Address - Phone:843-881-1638
Practice Address - Fax:843-881-4199
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-28
Last Update Date:2018-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC6906332B00000X
SCDGD.6906 GD1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies