Provider Demographics
NPI:1316331465
Name:MEERS, RYAN
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:
Last Name:MEERS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 9478
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43697-9478
Mailing Address - Country:US
Mailing Address - Phone:248-528-2116
Mailing Address - Fax:248-528-2963
Practice Address - Street 1:135 MERCHANT ST
Practice Address - Street 2:STE 270
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45246-3735
Practice Address - Country:US
Practice Address - Phone:513-771-7483
Practice Address - Fax:513-771-7484
Is Sole Proprietor?:No
Enumeration Date:2015-03-26
Last Update Date:2016-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.24696122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0137299Medicaid