NPIMap

Organization Active NPI

Ryan, James, Wiles, Patel & Olsen LLP

  • Dentist
  • Fayetteville, NC
National Provider Identifier
1750495693
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
Practice address
2029 Valleygate Dr
Suite 201
Fayetteville, NC 28304-3688
Phone
(910) 485-8884
Fax
(910) 485-8287
NPI assigned
Aug 18, 2006
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) 484-7070

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

2029 Valleygate Dr
Suite 201
Fayetteville, NC 28304-3688

Mailing address

2029 Valleygate Dr Ste 201
Fayetteville, NC 28304-3772
Phone (910) 485-8884

Other identifiers 1

IdentifierTypeStateIssuer
890289BMedicaidNC

Other names 1

  • Village Family Dental 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
This NPI is an additional NPI on the 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

Member organizations 2

Organizations listed as members of this organization in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 42

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 42

NPI Registry JSON

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760054400000",
    "number": "1750495693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2029 VALLEYGATE DR STE 201",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283043772",
            "telephone_number": "910-485-8884",
            "fax_number": "910-485-8287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2029 VALLEYGATE DR",
            "address_2": "SUITE 201",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283043688",
            "telephone_number": "910-485-8884",
            "fax_number": "910-485-8287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RYAN, JAMES, WILES, PATEL & OLSEN LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-18",
        "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": "910-484-7070"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890289B",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Village Family Dental",
            "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.