Ruoyu Pang, D.D.S., PH.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019.029419 Issued in IL

Practice address

340 S Austin Blvd
Apt 3K
Oak Park, IL 60304-1743

Phone

(708) 689-9556

NPI assigned

Aug 10, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1376092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376092800000",
    "number": "1104259407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 S AUSTIN BLVD",
            "address_2": "APT 3K",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603041743",
            "telephone_number": "708-689-9556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 S AUSTIN BLVD",
            "address_2": "APT 3K",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603041743",
            "telephone_number": "708-689-9556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANG",
        "first_name": "RUOYU",
        "name_prefix": "Dr.",
        "credential": "D.D.S., PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-10",
        "last_updated": "2013-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019.029419",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Oak Park, IL
• Providers in Oak Park, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2013; 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.