Provider Demographics
NPI:1750666251
Name:CALDWELL, GREGORY RYAN (DDS, MS)
Entity type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:RYAN
Last Name:CALDWELL
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9398 VISCOUNT BLVD STE 1A
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79925-8028
Mailing Address - Country:US
Mailing Address - Phone:915-227-6402
Mailing Address - Fax:915-598-6702
Practice Address - Street 1:9398 VISCOUNT BLVD STE 1A
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79925-8028
Practice Address - Country:US
Practice Address - Phone:915-598-6702
Practice Address - Fax:915-593-7478
Is Sole Proprietor?:No
Enumeration Date:2011-10-15
Last Update Date:2025-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX27275122300000X, 1223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics
No122300000XDental ProvidersDentist