MEDICARE: RYAN, JAMES, WILES, PATEL & OLSEN LLP

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	1223P0221X	Pediatric Dentistry

General Provider Information

NPI Number	:	1578415998
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RYAN, JAMES, WILES, PATEL & OLSEN LLP

Provider Business Mailing Address
First Line	:	2028 LITHO PL STE 300
Second Line	:
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28304-2538
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2980 RAY RD
Second Line	:
City	:	SPRING LAKE
State	:	NC
Zip	:	28390-7801
Country	:	US
Telephone Number	:	910-778-8485
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR OF ACQUISITIONS
Name	:	CHRISTINA C PATE
Credential	:
Telephone Number	:	910-484-7070

Provider Enumeration Date	:	02/10/2026
Last Update Date	:	02/17/2026

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