Individual provider Active NPI

Robert D Ruiz, DDS

  • Dentist
  • Corpus Christi, TX
National Provider Identifier
1225147929
Registry record updated Jul 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
17865 Issued in TX
Practice address
6262 Weber Rd
Suite 120
Corpus Christi, TX 78413-4006
Phone
(361) 851-2828
Fax
(361) 851-2830
NPI assigned
Aug 29, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 17865 TX Primary

Addresses

Primary practice location

6262 Weber Rd
Suite 120
Corpus Christi, TX 78413-4006

Mailing address

6262 Weber Rd
Suite 120
Corpus Christi, TX 78413-4006
Phone (915) 593-6661

Other identifiers 1

IdentifierTypeStateIssuer
009866701MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20230602000888 TX Practitioner - Dentist 5890061592 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
17865TXMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Centro de Salud Familiar la Fe, Inc Dentist CurrentSince Feb 7, 2023 Accepting new patients
Centro de Salud Familiar la Fe, Inc. CurrentSince Feb 7, 2023 Accepting new patients

Locations

1314 E Yandell Dr
El Paso, TX 79902

700 S Ochoa St
El Paso, TX 79901
Phone (915) 545-4550

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467936000000",
    "number": "1225147929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6262 WEBER RD",
            "address_2": "SUITE 120",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784134006",
            "telephone_number": "915-593-6661",
            "fax_number": "361-851-2830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6262 WEBER RD",
            "address_2": "SUITE 120",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784134006",
            "telephone_number": "361-851-2828",
            "fax_number": "361-851-2830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUIZ",
        "first_name": "ROBERT",
        "middle_name": "D",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2016-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "17865",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009866701",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Corpus Christi, TX

Sources for this page

Verify at the official NPI Registry.