Maksym Ruzanov, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

DN22016 Issued in FL

Practice address

3909 E Bay Dr Ste 205
Holmes Beach, FL 34217-1990

Phone

(941) 778-2204

NPI assigned

Jul 21, 2016

Last updated

Sep 5, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Enrolled in FL

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• All Smiles Sleep Solutions LLC

  • Durable Medical Equipment & Medical Supplies
  • Tampa, FL
  • NPI 1093224032
  NPD (past)

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

{
    "created_epoch": "1469059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567641600000",
    "number": "1134572498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1505 MALLARD LN",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342393750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3909 E BAY DR STE 205",
            "city": "HOLMES BEACH",
            "state": "FL",
            "postal_code": "342171990",
            "telephone_number": "941-778-2204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUZANOV",
        "first_name": "MAKSYM",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-07-21",
        "last_updated": "2019-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN22016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Drashti Darshan Patel
• Paul J Barrese MD PA
• Stephen G Pelham, MD
• Publix Super Markets, Inc. (Publix Pharmacy #0681)
• Reed Fitness and Physical Therapy
• Todd Schechter
• The Healing Well Acupuncture & Integrated Medicine, LLC
• Benjamin Tindal, D.M.D
• Walgreen Co (Walgreens #13850)

• Dentist in Holmes Beach, FL
• Providers in Holmes Beach, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.