Penelope Phuong Minh Ruoff, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

DE60864449 Issued in WA

Practice address

16549 Aurora Ave N
Shoreline, WA 98133-5308

Phone

(206) 533-2600

NPI assigned

Mar 15, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: pruoff1186410@wm.providencedirect.org

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

{
    "created_epoch": "1521072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562889600000",
    "number": "1154824100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9307 NE 118TH LN APT 2-201",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980343632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16549 AURORA AVE N",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981335308",
            "telephone_number": "206-533-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUOFF",
        "first_name": "PENELOPE",
        "middle_name": "PHUONG MINH",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-15",
        "last_updated": "2019-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE60864449",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph Mark Rubin
• Stivaly Rubio
• Abraham Ruiz
• Aisha P Ruler, M.D.
• Richard Runge
• Maria Jeanette Russell, PA-C
• Jonas Rutledge
• Andrea Ryan, MACCC-SLP
• Bruce Harlan Ryan, D.C.
• Nicole R Ryerson, IBCLC

• Dentist in Shoreline, WA
• Providers in Shoreline, WA by specialty
• Dentist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2019; 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.