Active NPI
Kathleen E. Rueter, DMD, MS, LLC
- Periodontics
- Bend, OR
National Provider Identifier
1003064247
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- D8905
- Practice address
- 499 SW Upper Terrace Dr
Suite B
Bend, OR 97702-1582 - Phone
- (541) 388-7421
- NPI assigned
- Aug 29, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | D8905 | OR | Primary |
Addresses
Primary practice location
499 SW Upper Terrace Dr
Suite B
Bend, OR 97702-1582
Mailing address
499 SW Upper Terrace Dr
Suite B
Bend, OR 97702-1582
Phone (541) 388-7421
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Dec 15, 2017 through Dec 15, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D8905 | OR | MD | Periodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1219968000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1219968000000",
"number": "1003064247",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "499 SW UPPER TERRACE DR",
"address_2": "SUITE B",
"city": "BEND",
"state": "OR",
"postal_code": "977021582",
"telephone_number": "541-388-7421"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "499 SW UPPER TERRACE DR",
"address_2": "SUITE B",
"city": "BEND",
"state": "OR",
"postal_code": "977021582",
"telephone_number": "541-388-7421"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUETER",
"first_name": "KATHLEEN",
"middle_name": "E.",
"name_prefix": "Dr.",
"credential": "DMD, MS, LLC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-08-29",
"last_updated": "2008-08-29",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "OR",
"license": "D8905",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bend, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.