Provider Demographics
NPI:1669614137
Name:LANMAN, RYAN JAMES (DDS MSD)
Entity type:Individual
Prefix:DR
First Name:RYAN
Middle Name:JAMES
Last Name:LANMAN
Suffix:
Gender:M
Credentials:DDS MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3621 NW 63RD ST # I
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73116-2041
Mailing Address - Country:US
Mailing Address - Phone:405-840-2834
Mailing Address - Fax:
Practice Address - Street 1:3621 NW 63RD ST STE I
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73116-2041
Practice Address - Country:US
Practice Address - Phone:405-840-2834
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-30
Last Update Date:2023-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK62721223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics