NPIMap

Organization Active NPI

Ryan, James, Wiles, Patel & Olsen LLP

Doing business as Southeastern Dental Specialists

  • Dentist
  • Fayetteville, NC
National Provider Identifier
1346473279
Registry record updated Oct 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
RYAN, JAMES, WILES, PATEL & OLSEN LLP
Doing business as
Southeastern Dental Specialists
Practice address
2028 Litho PL Ste 200
Fayetteville, NC 28304
Phone
(910) 689-1475
Fax
(910) 323-4879
NPI assigned
Aug 26, 2009
Last updated
Oct 10, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Christina C Pate
Title
Revenue Cycle Director
Phone
(910) 485-7070

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X NU Primary

Addresses

Primary practice location

2028 Litho PL Ste 200
Fayetteville, NC 28304

Mailing address

2028 Litho PL Ste 300
Fayetteville, NC 28304-2538
Phone (910) 485-7070

Other names 1

  • Southeastern Dental Specialists Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150608002836 NC Part B Supplier - Clinic/Group Practice 8628399227 Receives reassigned benefits from 37 practitioners
8 other NPIs on this enrollment
Practice locations: Fayetteville, NC

Other NPIs on the same Medicare enrollment 8

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Ryan James Wiles Patel Olsen LLP8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3551 Dunn Rd
Ste 102
Eastover, NC 28312
Phone (910) 437-0232

1031 Weiss Ave
#101
Fayetteville, NC 28305
Phone (910) 486-4180

1031 Weiss Ave
#201
Fayetteville, NC 28305
Phone (910) 689-1475

109 McAlpine Ln
Laurinburg, NC 28352
Phone (910) 276-6640

312 W McLean St
Saint Pauls, NC 28384
Phone (910) 446-1130

Practitioners & affiliated clinicians

Practitioners 76

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 76

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1251244800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760054400000",
    "number": "1346473279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2028 LITHO PL STE 300",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283042538",
            "telephone_number": "910-485-7070",
            "fax_number": "910-485-1151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2028 LITHO PL STE 200",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "28304",
            "telephone_number": "910-689-1475",
            "fax_number": "910-323-4879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RYAN, JAMES, WILES, PATEL & OLSEN LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-26",
        "last_updated": "2025-10-10",
        "certification_date": "2025-10-10",
        "status": "A",
        "authorized_official_last_name": "PATE",
        "authorized_official_first_name": "CHRISTINA",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "REVENUE CYCLE DIRECTOR",
        "authorized_official_telephone_number": "910-485-7070"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southeastern Dental Specialists",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fayetteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.