Provider Demographics
NPI:1225114630
Name:DOWDEN, RODERICK RYAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:RODERICK
Middle Name:RYAN
Last Name:DOWDEN
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 1:9623 WINDERMERE BLVD
Mailing Address - Street 2:STE A
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46037
Mailing Address - Country:US
Mailing Address - Phone:317-594-0461
Mailing Address - Fax:317-594-0477
Practice Address - Street 1:9623 WINDERMERE BLVD
Practice Address - Street 2:STE A
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46037
Practice Address - Country:US
Practice Address - Phone:317-594-0461
Practice Address - Fax:317-594-0477
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12009659122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist