Ruidan Ma, DDS, MS

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

38553 Issued in TX

Practice address

2203 Spring Stuebner Rd Ste 400
Spring, TX 77389-5364

Phone

(615) 669-9451

NPI assigned

Aug 6, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

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.

• Timothy Bennett Dental Corporation

  dba Walerga Dental Group

  • General Practice Dentistry
  • Antelope, CA
  • NPI 1750471140
  NPD (past)

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

{
    "created_epoch": "1501977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737936000000",
    "number": "1073038519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2203 SPRING STUEBNER RD STE 400",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "773895364",
            "telephone_number": "615-669-9451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2203 SPRING STUEBNER RD STE 400",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "773895364",
            "telephone_number": "615-669-9451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MA",
        "first_name": "RUIDAN",
        "name_prefix": "Dr.",
        "credential": "DDS, MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-06",
        "last_updated": "2025-01-27",
        "certification_date": "2025-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "101635",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "IL",
            "license": "019031847",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "101635",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "TX",
            "license": "38553",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA DENTAL BOARD",
            "identifier": "101635",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS STATE BOARD OF DENTAL EXAMINERS",
            "identifier": "38553",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James C Lyles Jr., D.D.S
• Layla Lynch
• Stephanie Lynch
• Madeline S Lynn, CRNP
• M&a Legacy of Houston Inc
• Mary Mable
• David Randolph Mabry, M.D.
• Noelle Niantee Mack-Peterson
• Jennifer P Mackey
• Tamitha Elaine Mackey, FNP

• Orthodontics and Dentofacial Orthopedics Dentistry in Spring, TX
• Providers in Spring, TX by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2025; 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.