Provider Demographics
NPI:1316100100
Name:MURPHY, RYAN (DDS)
Entity type:Individual
Prefix:DR
First Name:RYAN
Middle Name:
Last Name:MURPHY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1835 1ST AVE
Mailing Address - Street 2:21ST DENTAL CO
Mailing Address - City:STERLING
Mailing Address - State:IL
Mailing Address - Zip Code:61081-1201
Mailing Address - Country:US
Mailing Address - Phone:815-626-9600
Mailing Address - Fax:
Practice Address - Street 1:D STREET MCBH
Practice Address - Street 2:BUILDING 3089
Practice Address - City:KANEOHE
Practice Address - State:HI
Practice Address - Zip Code:96863
Practice Address - Country:US
Practice Address - Phone:808-257-3100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-02
Last Update Date:2016-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.027685122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist