Active NPI
Socorro Ruiz
- Dental Hygienist
- Fort Mohave, AZ
National Provider Identifier
1164181004
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- H06228
- Practice address
- 5677 S Highway 95
Fort Mohave, AZ 86426-6049 - Phone
- (928) 788-3459
- NPI assigned
- Dec 8, 2021
- Last updated
- Dec 8, 2021
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | H06228 | AZ | Primary |
Addresses
Primary practice location
5677 S Highway 95
Fort Mohave, AZ 86426-6049
Mailing address
5677 S Highway 95
Fort Mohave, AZ 86426-6049
Phone (928) 788-3459
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 |
|---|---|---|---|
| H06228 | AZ | MD | Dental Hygienist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| CL Valley Dental | Current | Accepting new patients |
Locations
5677 S Highway 95
Fort Mohave, AZ 86426
Phone (928) 788-3359
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Dental Clinic/Center
- Fort Mohave, AZ
- NPI 1588316806
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1638921600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1638921600000",
"number": "1164181004",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5677 S HIGHWAY 95",
"city": "FORT MOHAVE",
"state": "AZ",
"postal_code": "864266049",
"telephone_number": "928-788-3459"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5677 S HIGHWAY 95",
"city": "FORT MOHAVE",
"state": "AZ",
"postal_code": "864266049",
"telephone_number": "928-788-3459"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUIZ",
"first_name": "SOCORRO",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-12-08",
"last_updated": "2021-12-08",
"certification_date": "2021-12-08",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "AZ",
"license": "H06228",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Mohave, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.