Individual provider Active NPI

Denise R. Ruffin, DDS

  • Dentist
  • Meridian, MS
National Provider Identifier
1063594588
Registry record updated May 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
3208-01 Issued in MS
Practice address
2701 Davis Street
Meridian, MS 39301-5708
Phone
(601) 693-0118
Fax
(844) 778-8922
NPI assigned
Oct 20, 2006
Last updated
May 3, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 3208-01 MS Primary

Addresses

Primary practice location

2701 Davis Street
Meridian, MS 39301-5708

Mailing address

2701 Davis Street
Meridian, MS 39301-5708
Phone (601) 693-0118

Other identifiers 1

IdentifierTypeStateIssuer
000660392MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151217000373 MS Order and Referring Only - DentistPractitioner - Dentist 4082801097

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3208-01MSMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Greater Meridian Health Clinic, Inc PastSince Dec 2, 2010 Accepting new patients
Greater Meridian Health Clinic, Inc. Past Accepting new patients

Networks

  • LA PPO C-SNP

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EJDBBA

Organizations & group practices 2

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": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714694400000",
    "number": "1063594588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 DAVIS STREET",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393015708",
            "telephone_number": "601-693-0118",
            "fax_number": "601-553-8175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 DAVIS STREET",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393015708",
            "telephone_number": "601-693-0118",
            "fax_number": "844-778-8922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUFFIN",
        "first_name": "DENISE",
        "middle_name": "R.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-20",
        "last_updated": "2024-05-03",
        "certification_date": "2024-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MS",
            "license": "3208-01",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000660392",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, MS

Sources for this page

Verify at the official NPI Registry.