Provider Demographics
NPI:1558780460
Name:HINKLE, RYAN M (DDS, MD)
Entity Type:Individual
Prefix:DR
First Name:RYAN
Middle Name:M
Last Name:HINKLE
Suffix:
Gender:M
Credentials:DDS, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:805 TURTLE CREEK DR
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75701-1937
Mailing Address - Country:US
Mailing Address - Phone:903-592-1664
Mailing Address - Fax:903-593-6065
Practice Address - Street 1:805 TURTLE CREEK DR
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75701-1937
Practice Address - Country:US
Practice Address - Phone:903-592-1664
Practice Address - Fax:903-593-4269
Is Sole Proprietor?:No
Enumeration Date:2014-04-08
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS7234204E00000X, 204E00000X
TX348301223S0112X, 1223S0112X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXS7234OtherMEDICAL LICENSE