Provider Demographics
NPI:1841703170
Name:RYAN, VALERIE ANNE (DDS)
Entity type:Individual
Prefix:DR
First Name:VALERIE
Middle Name:ANNE
Last Name:RYAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1114 BISHOP WALSH RD
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21502-1904
Mailing Address - Country:US
Mailing Address - Phone:540-383-9784
Mailing Address - Fax:
Practice Address - Street 1:428 NATIONAL HWY
Practice Address - Street 2:
Practice Address - City:LAVALE
Practice Address - State:MD
Practice Address - Zip Code:21502-7129
Practice Address - Country:US
Practice Address - Phone:301-722-5850
Practice Address - Fax:301-722-4960
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-08
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD164571223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty