Healthcare Provider Details

I. General information

NPI: 1982957312
Provider Name (Legal Business Name): RYAN MCFADDEN D.M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/23/2012
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5411 E BUSCH BLVD
TEMPLE TERRACE FL
33617-5417
US

IV. Provider business mailing address

5411 E BUSCH BLVD
TEMPLE TERRACE FL
33617-5417
US

V. Phone/Fax

Practice location:
  • Phone: 813-985-0088
  • Fax: 813-345-2892
Mailing address:
  • Phone: 813-985-0088
  • Fax: 813-345-2892

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN20057
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: