Wyatt M Ruffin Jr., DDS

Primary specialty

DentistTaxonomy code 122300000X

License

0401006433 Issued in VA

Practice address

3940 Airline Blvd
Suite 114
Chesapeake, VA 23321-3329

Phone

(757) 465-4884

Fax

(757) 465-4884

NPI assigned

Sep 25, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Nansemond Suffolk Oral Care

  • General Practice Dentistry
  • Chesapeake, VA
  • NPI 1720159437
  NPD (past) Authorized official

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1033210943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3940 AIRLINE BLVD",
            "address_2": "SUITE 114",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233213329",
            "telephone_number": "757-465-4884",
            "fax_number": "757-465-4884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3940 AIRLINE BLVD",
            "address_2": "SUITE 114",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233213329",
            "telephone_number": "757-465-4884",
            "fax_number": "757-465-4884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUFFIN",
        "first_name": "WYATT",
        "middle_name": "M",
        "name_suffix": "Jr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401006433",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7821743",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Toni Yvette Rudisill, LPC
• Ruetzel Gynecology & Obstetrics
• Craig H Ruetzel, M.D.
• Gillian G.P. Ruffin, RPH
• Tierra W Ruffin, LPC
• Dominick A Ruggiero, PA-C
• Kayla Ruiz
• Leigh Rumberger, LPC
• Amiyah Rumble
• Natalie Runser

• Dentist in Chesapeake, VA
• Providers in Chesapeake, VA by specialty
• Dentist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.