Candace Susan Ruff, BS, DMD

Individual provider Active NPI General Practice Dentistry · Homer Glen, IL

NPI 1104473966 · NPPES record last updated Aug 26, 2019

Key facts

NPI
1104473966
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
019032365 (IL)
Practice address
14403 S Bell Rd
Homer Glen, IL 60491-7881
Phone
(708) 966-4018
NPI assigned
Aug 26, 2019
Sex
Female
Sole proprietor
No

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 and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Aug 31, 2021 through Aug 31, 2027

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Bachelor of Science

State licenses

LicenseStateTypeSpecialty
019032365ILMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Ashton Dental PC General Practice Past
since Sep 1, 2019
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 019032365 IL Yes

Addresses

Primary practice location

14403 S Bell Rd
Homer Glen, IL 60491-7881

Mailing address

14403 S Bell Rd
Homer Glen, IL 60491-7881

Other practice location 1

2503 N Halsted St
Chicago, IL 60614-3522
Phone (773) 386-2503

Other providers in Homer Glen, IL

All providers in Homer Glen, IL · General Practice Dentistry in Illinois

Sources for this page

Verify at the official NPI Registry.