MEDICARE: RYAN GABRIEL MURPHY DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program
2	122300000X	Dentist	2025027671	MO

General Provider Information

NPI Number	:	1376319855
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RYAN GABRIEL MURPHY DDS

Provider Business Mailing Address
First Line	:	6531 SAN BONITA AVE APT 3E
Second Line	:
City	:	CLAYTON
State	:	MO
Zip	:	63105-3192
Country	:	US
Telephone Number	:	425-213-9517
Fax Number	:

Provider Business Practice Location Address
First Line	:	6531 SAN BONITA AVE APT 3E
Second Line	:
City	:	CLAYTON
State	:	MO
Zip	:	63105-3192
Country	:	US
Telephone Number	:	425-213-9517
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/27/2023
Last Update Date	:	12/05/2025

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