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DR. RYAN JAMES DAVIS DMD, MS
NPI 1396916649
Dentist - Periodontics in Peoria, IL

Active since March 14, 2008PECOS Enrolled
1717 W CANDLETREE DR STE A, PEORIA, IL 61614(309) 360-8502 Get Directions Write a Review

NPPES record last updated: October 17, 2012. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Dr. Ryan James Davis Dmd, Ms NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. RYAN JAMES DAVIS DMD, MS (NPI 1396916649) is an individual periodontics provider in Peoria, Illinois, licensed in Illinois (021.002357) and active in the NPI registry since March 2008. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1396916649
Entity TypeIndividualMale
Primary Taxonomy1223P0300X
Provider Legal NameDR. RYAN JAMES DAVISCredential: DMD, MS
Location Address1717 W CANDLETREE DR STE APeoria, IL 61614-1592
Mailing Address1717 W Candletree Dr Ste APeoria, IL 61614-1592 · (309) 360-8502
Phone(309) 360-8502
Sole ProprietorYes
Enumeration DateMarch 14, 2008
Last NPPES UpdateOctober 17, 2012
✔ NPI 1396916649 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDentist · PeriodonticsDental Providers
Taxonomy Code1223P0300X
License✔ Licensed in IL · 021.002357
Definition
That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues.
Also ListedDentistTaxonomy 122300000X · License 019.027.427 (IL)
1717 W CANDLETREE DR STE A, Peoria, IL 61614
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Humana.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Ryan James Davis Dmd, Ms is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Ryan Davis reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Saint Francis Medical Center
5.5 mi
Family Medicine
200 E PENNSYLVANIA AVE
Peoria, IL 61603
  • Reassigned Medicare billing, Illinois enrollment
  • 157 clinicians in this Medicare group
NPI 1306890033 (800) 589-6070

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 61614 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$85.71 typical visit price
range $54.80 – $168.44
Typical copayment $21.42 (range $13.70 – $42.11)
Most-billed visit code 99203
Established Patient
$68.64 typical visit price
range $17.16 – $136.56
Typical copayment $17.16 (range $4.29 – $34.14)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ryan Davis's NPI number?

The NPI number for Ryan Davis is 1396916649. It was assigned to this individual provider in the NPPES registry on March 14, 2008.

Where is Ryan Davis located?

Ryan Davis practices at 1717 W Candletree Dr Ste A, Peoria, IL 61614. The listed phone number is (309) 360-8502.

What is Ryan Davis's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Periodontics, with taxonomy code 1223P0300X.

Is Ryan Davis enrolled in Medicare?

Yes. Ryan Davis is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Ryan Davis's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Ryan Davis reassigns Medicare benefits to Saint Francis Medical Center (Peoria, IL). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Ryan Davis's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Ryan Davis accept?

Health plans from Humana list Ryan Davis as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Ryan Davis was last updated on October 17, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.