Individual provider Active NPI

Dale R Ruemping, D.D.S. , M.S.D.

  • Pediatric Dentistry
  • Spokane Valley, WA
National Provider Identifier
1104983709
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
5676 Issued in WA
Practice address
12615 E Mission Ave
Suite 312
Spokane Valley, WA 99216-1047
Phone
(509) 926-1234
Fax
(509) 926-1701
NPI assigned
Jan 2, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 5676 WA Primary

Addresses

Primary practice location

12615 E Mission Ave
Suite 312
Spokane Valley, WA 99216-1047

Mailing address

12615 E Mission Ave
Suite 312
Spokane Valley, WA 99216-1047
Phone (509) 926-1234

Other identifiers 1

IdentifierTypeStateIssuer
5015516MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
5676WAMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
J Blake, DMD, PS Pediatric Dentistry Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104983709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12615 E MISSION AVE",
            "address_2": "SUITE 312",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992161047",
            "telephone_number": "509-926-1234",
            "fax_number": "509-926-1701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12615 E MISSION AVE",
            "address_2": "SUITE 312",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992161047",
            "telephone_number": "509-926-1234",
            "fax_number": "509-926-1701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUEMPING",
        "first_name": "DALE",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "D.D.S. , M.S.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "WA",
            "license": "5676",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5015516",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane Valley, WA

Sources for this page

  • 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.