Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Ryan David Bastyr, DMD

Individual provider Dentist · NPI 1609759323

Dr. Ryan David Bastyr, DMD is a Dentist in Great Lakes, Illinois. Practices as a sole proprietor. Licensed in Pennsylvania.

Licensed in
PA
In the registry since
2025
What do these letters mean?
DMD — Doctor of Dental Medicine
A dentist. Identical training and licensing to a DDS.

See every abbreviation used in this directory →

Practice location Address checks out

2410 Sampson St
Great Lakes, IL 60088-2942
Phone: (847) 688-2469
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence DS045379 (PA)

Record details

NPI number1609759323
Entity typeIndividual (Type 1)
GenderMale
Credentials DMD
Sole proprietorYes
NPI enumeratedJuly 29, 2025
Last updated in NPPESJuly 29, 2025
Certification dateJune 30, 2025
Mailing address420 Timberlake Dr, Venetia, PA 15367-1394

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