Individual provider Active NPI

Doribeth Ruiz, DMD

  • Pediatric Dentistry
  • Fort Myers, FL
National Provider Identifier
1023561826
Registry record updated Nov 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
DN25342 Issued in FL
Practice address
3700 Central Ave
Fort Myers, FL 33901-7649
Phone
(239) 387-1587
NPI assigned
Jul 27, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X S6-148 NV
Pediatric Dentistry 1223P0221X DN25342 FL Primary

Addresses

Primary practice location

3700 Central Ave
Fort Myers, FL 33901-7649

Mailing address

3700 Central Ave
Fort Myers, FL 33901-7649
Phone (239) 387-1587

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DN25342FLMDPediatric Dentist
S6-148NVMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Dentistry of Cape Coral Pediatric Dentistry PastSince Oct 1, 2021 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1469577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699228800000",
    "number": "1023561826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3700 CENTRAL AVE",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339017649",
            "telephone_number": "239-387-1587",
            "fax_number": "239-922-1369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 CENTRAL AVE",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339017649",
            "telephone_number": "239-387-1587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUIZ",
        "first_name": "DORIBETH",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-27",
        "last_updated": "2023-11-06",
        "certification_date": "2023-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NV",
            "license": "S6-148",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "FL",
            "license": "DN25342",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.