Individual provider Active NPI

Albert G Ruezga, DDS

  • General Practice Dentistry
  • Pahrump, NV
National Provider Identifier
1124172267
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
4065 Issued in NV
Practice address
2340 E Calvada Blvd
1
Pahrump, NV 89048-5880
Phone
(775) 751-5888
NPI assigned
Jan 23, 2007
Sex
Male
Sole proprietor
No

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
General Practice Dentistry 1223G0001X 4065 NV Primary

Addresses

Primary practice location

2340 E Calvada Blvd
1
Pahrump, NV 89048-5880

Mailing address

2340 E Calvada Blvd
1
Pahrump, NV 89048-5880
Phone (775) 751-5888

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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
I20150828000562 NV Order and Referring Only - DentistPractitioner - Dentist 6103132675

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Albert G Ruezga, Inc. 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": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124172267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2340 E CALVADA BLVD",
            "address_2": "1",
            "city": "PAHRUMP",
            "state": "NV",
            "postal_code": "890485880",
            "telephone_number": "775-751-5888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2340 E CALVADA BLVD",
            "address_2": "1",
            "city": "PAHRUMP",
            "state": "NV",
            "postal_code": "890485880",
            "telephone_number": "775-751-5888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUEZGA",
        "first_name": "ALBERT",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NV",
            "license": "4065",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pahrump, NV

Sources for this page

Verify at the official NPI Registry.