Healthcare Provider Details

I. General information

NPI: 1124181730
Provider Name (Legal Business Name): RYAN N ESKRIDGE DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/18/2006
Last Update Date: 10/25/2022
Certification Date: 08/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10401 SAWMILL PKWY STE 100
POWELL OH
43065-7451
US

IV. Provider business mailing address

10401 SAWMILL PKWY STE 100
POWELL OH
43065-7451
US

V. Phone/Fax

Practice location:
  • Phone: 614-792-0063
  • Fax: 614-792-3376
Mailing address:
  • Phone: 614-792-0063
  • Fax: 614-792-3376

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number21580
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: