Provider Demographics
NPI:1790148773
Name:KAY, RYAN (DMD, MS)
Entity Type:Individual
Prefix:DR
First Name:RYAN
Middle Name:
Last Name:KAY
Suffix:
Gender:M
Credentials:DMD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:285 N EL CAMINO REAL STE 210
Mailing Address - Street 2:
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-5385
Mailing Address - Country:US
Mailing Address - Phone:760-753-3533
Mailing Address - Fax:
Practice Address - Street 1:285 N EL CAMINO REAL STE 210
Practice Address - Street 2:
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-5385
Practice Address - Country:US
Practice Address - Phone:760-753-3533
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-29
Last Update Date:2018-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA645711223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice