Individual provider Active NPI

Helena Ruderman, D.D.S.

  • General Practice Dentistry
  • Wheeling, IL
National Provider Identifier
1154550184
Registry record updated Jul 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019.025688 Issued in IL
Practice address
309 E Dundee Rd
Wheeling, IL 60090-3107
Phone
(847) 229-1700
NPI assigned
Jul 12, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 12, 2009

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 019.025688 IL Primary

Addresses

Primary practice location

309 E Dundee Rd
Wheeling, IL 60090-3107

Mailing address

3609 Countryside LN
Glenview, IL 60025-3721
Phone (847) 729-7316

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
019.025688ILMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Helena Ruderman, DDS General Practice Past Accepting new patients
Lucky Smile Dental LLC PastSince Apr 28, 2024 Accepting new patients

Organizations & group practices 2

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": "1247356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1247356800000",
    "number": "1154550184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3609 COUNTRYSIDE LN",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600253721",
            "telephone_number": "847-729-7316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 E DUNDEE RD",
            "city": "WHEELING",
            "state": "IL",
            "postal_code": "600903107",
            "telephone_number": "847-229-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDERMAN",
        "first_name": "HELENA",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-12",
        "last_updated": "2009-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019.025688",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheeling, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2009; 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.