Provider Demographics
NPI:1821526104
Name:ANDREWS, NOLAN RYAN (DDS)
Entity Type:Individual
Prefix:MR
First Name:NOLAN
Middle Name:RYAN
Last Name:ANDREWS
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 1:535 S. MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:EL DORADO
Mailing Address - State:KS
Mailing Address - Zip Code:67042
Mailing Address - Country:US
Mailing Address - Phone:316-321-4222
Mailing Address - Fax:316-321-3840
Practice Address - Street 1:535 S. MAIN STREET
Practice Address - Street 2:
Practice Address - City:EL DORADO
Practice Address - State:KS
Practice Address - Zip Code:67042
Practice Address - Country:US
Practice Address - Phone:316-321-4222
Practice Address - Fax:316-321-3840
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-31
Last Update Date:2019-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS614021223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice