Provider Demographics
NPI:1104954999
Name:WATKINS, RYAN PATRICK (DDS)
Entity type:Individual
Prefix:DR
First Name:RYAN
Middle Name:PATRICK
Last Name:WATKINS
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 1:2615 VIA ECO
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92010-8348
Mailing Address - Country:US
Mailing Address - Phone:805-405-4975
Mailing Address - Fax:
Practice Address - Street 1:950 VISTA VILLAGE DR
Practice Address - Street 2:
Practice Address - City:VISTA
Practice Address - State:CA
Practice Address - Zip Code:92084-6064
Practice Address - Country:US
Practice Address - Phone:760-274-0993
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-01
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA521301223G0001X, 1223D0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223D0004XDental ProvidersDentistDental Anesthesiology
No1223G0001XDental ProvidersDentistGeneral Practice