Healthcare Provider Details

I. General information

NPI: 1356257349
Provider Name (Legal Business Name): RYAN EDWARD SCAIFE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

702 W SYCAMORE ST
COLDWATER OH
45828-1623
US

IV. Provider business mailing address

2020 JEFFERSON ST
MARIA STEIN OH
45860-9552
US

V. Phone/Fax

Practice location:
  • Phone: 419-678-3170
  • Fax:
Mailing address:
  • Phone: 740-534-3267
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number30.028646
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: