Active NPI
Ronald J Pruhs, D.D.S.
- Pediatric Dentistry
- Saint Francis, WI
National Provider Identifier
1255628491
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 5000087-15
- Practice address
- 4120 S Lake Dr
Apt. 251
Saint Francis, WI 53235-5954 - Phone
- (920) 693-2992
- NPI assigned
- Jul 8, 2011
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 5000087-15 | WI | Primary |
Addresses
Primary practice location
4120 S Lake Dr
Apt. 251
Saint Francis, WI 53235-5954
Mailing address
4120 S Lake Dr
Apt. 251
Saint Francis, WI 53235-5954
Phone (920) 693-2992
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 |
|---|---|---|---|
| 5000087-15 | WI | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1310083200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1310083200000",
"number": "1255628491",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4120 S LAKE DR",
"address_2": "APT. 251",
"city": "SAINT FRANCIS",
"state": "WI",
"postal_code": "532355954",
"telephone_number": "920-693-2992"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4120 S LAKE DR",
"address_2": "APT. 251",
"city": "SAINT FRANCIS",
"state": "WI",
"postal_code": "532355954",
"telephone_number": "920-693-2992"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRUHS",
"first_name": "RONALD",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-07-08",
"last_updated": "2011-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "WI",
"license": "5000087-15",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Francis, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.