RYAN SERRA, D.M.D., M.S. — NPI 1740493907 (Licensed Doctor of Dental Surgery (DDS) / Doctor of Medicine in Dentistry (DMD) in LAKEWOOD RANCH, FL)

CMS-1500 Box 24J / 33a • NPI

1740493907

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

1223P0300X

Licensed Doctor of Dental Surgery (DDS) / Doctor of Medicine in Dentistry (DMD)

Box 32 Service Location & ZIP+4

9126 TOWN CENTER PKWY STE 101, LAKEWOOD RANCH, FL, 34202-5052

✓ 9-Digit EDI 837 ZIP+4 (34202-5052)

Practice Phone & Referral Fax

(941) 236-5695

Direct NPPES Verification Line

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1740493907 (RYAN SERRA, D.M.D., M.S.) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1740493907` (NPI-1 Individual Practitioner)
Provider / Legal Name	RYAN SERRA, D.M.D., M.S.
Plain-English Specialty	Licensed Doctor of Dental Surgery (DDS) / Doctor of Medicine in Dentistry (DMD) NUCC Code: `1223P0300X` (Dentist, Periodontics)
Certifying / Licensing Body	American Dental Association (ADA) / State Board of Dental Examiners
Practice Location Address	9126 TOWN CENTER PKWY STE 101, LAKEWOOD RANCH, FL, 34202-5052
Practice Telephone / Fax	Tel: (941) 236-5695
Administrative Mailing Address	129 52ND ST, HOLMES BEACH, FL, 34217-1716
Enumeration & Last Sync	Enumerated: 2007-05-07 \| CMS Record Updated: 2022-07-22

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

9126 TOWN CENTER PKWY STE 101, LAKEWOOD RANCH, FL, 34202-5052

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Plain-English Taxonomy & CMS Crosswalk (1223P0300X)

What Does Taxonomy Code 1223P0300X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 1223P0300X translates to:
"Licensed Doctor of Dental Surgery (DDS) / Doctor of Medicine in Dentistry (DMD)"

CMS-1500 Medicare Specialty Crosswalk: Standard HIPAA X12N 837P / CMS-1500
Certifying / Accrediting Authority: American Dental Association (ADA) / State Board of Dental Examiners
Clinical Scope: Routine 6-month dental checkups, toothache, dental abscess, bleeding gums (periodontitis), or wisdom tooth extraction.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (RYAN SERRA, D.M.D., M.S.)

Typical CPT / Diagnostic Procedures:

Comprehensive Oral Evaluation, Digital Dental Radiographs & Prophylaxis
Restorative Composite Fillings, Crowns, Endodontic Root Canal & Extractions

Common Therapeutic Classes:

Amoxicillin, Metronidazole & Clindamycin (Odontogenic Infections)
Chlorhexidine Gluconate 0.12% Oral Rinse & High-Fluoride Varnish

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`122300000X` — Dentist Plain English: Licensed Doctor of Dental Surgery (DDS) / Doctor of Medicine in Dentistry (DMD)	State: NC \| License: `8349` \| Primary: Secondary
`1223P0300X` — Dentist, Periodontics Plain English: Licensed Doctor of Dental Surgery (DDS) / Doctor of Medicine in Dentistry (DMD)	State: OH \| License: `30.023093` \| Primary: Secondary
`1223P0300X` — Dentist, Periodontics Plain English: Licensed Doctor of Dental Surgery (DDS) / Doctor of Medicine in Dentistry (DMD)	State: FL \| License: `DN27127` \| Primary: Yes (Primary)

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RYAN SERRA, D.M.D., M.S. (NPI #1740493907)