Active NPI
Ross Jacob Ruder, DDS
- Dentist
- Santa Rosa Beach, FL
National Provider Identifier
1124510557
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 23394
- Practice address
- 5399 E County Highway 30a
Santa Rosa Beach, FL 32459-6717 - Phone
- (850) 231-3736
- NPI assigned
- Jun 1, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 23394 | FL | Primary |
Addresses
Primary practice location
5399 E County Highway 30a
Santa Rosa Beach, FL 32459-6717
Mailing address
5399 E County Highway 30a
Santa Rosa Beach, FL 32459-6717
Phone (850) 231-3736
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
| License | State | Type | Specialty |
|---|---|---|---|
| 23394 | FL | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1527811200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1527811200000",
"number": "1124510557",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5399 E COUNTY HIGHWAY 30A",
"city": "SANTA ROSA BEACH",
"state": "FL",
"postal_code": "324596717",
"telephone_number": "850-231-3736"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5399 E COUNTY HIGHWAY 30A",
"city": "SANTA ROSA BEACH",
"state": "FL",
"postal_code": "324596717",
"telephone_number": "850-231-3736"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUDER",
"first_name": "ROSS",
"middle_name": "JACOB",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-06-01",
"last_updated": "2018-06-01",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "FL",
"license": "23394",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Rosa Beach, FL
- Kiran Sehdev Robertson, MD
- Stephony L Robinson, APN
- Richard Allen Rodrigue Jr., PHARM D
- George Norman Roll, PA-C
- Elizabeth Jeanine Rousso, LPC, LMHC
- Rural Primary Care South-Walton, Inc.
- Raphael Alexander Rusynyk, D.O.
- Heather Rutkowski, RPH
- Elena Ryazhapova, PHARMD
- Sacred Heart Medical Oncology Group
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.