Provider Demographics
NPI:1013264928
Name:RYAN, PAIGE STHEN (DDS)
Entity Type:Individual
Prefix:DR
First Name:PAIGE
Middle Name:STHEN
Last Name:RYAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:PAIGE
Other - Middle Name:NICHOLE
Other - Last Name:STHEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:PO BOX 398
Mailing Address - Street 2:
Mailing Address - City:KOTZEBUE
Mailing Address - State:AK
Mailing Address - Zip Code:99752-0398
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1310 E DIMOND BLVD STE 3
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99515-2031
Practice Address - Country:US
Practice Address - Phone:907-336-7337
Practice Address - Fax:907-336-7338
Is Sole Proprietor?:No
Enumeration Date:2012-08-09
Last Update Date:2020-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK1425122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist