Individual provider Active NPI

Peter Joseph Ruggiero, D.D.S.

  • Dentist
  • Cedar Rapids, IA
National Provider Identifier
1366824773
Registry record updated Jul 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DDS-09218 Issued in IA
Practice address
4201 1St Ave SE
Cedar Rapids, IA 52402-3144
Phone
(319) 364-7108
Fax
(319) 364-6529
NPI assigned
Jun 22, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DDS-09218 IA Primary

Addresses

Primary practice location

4201 1St Ave SE
Cedar Rapids, IA 52402-3144

Mailing address

4201 1St Ave SE
Cedar Rapids, IA 52402-3144
Phone (319) 364-7108

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
DDS-09218IAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Peter Ruggiero DDS PC CurrentSince Jul 4, 2021 Accepting new patients

Locations

4201 1st Ave SE
Cedar Rapids, IA 52402
Phone (319) 364-7108

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1434931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625097600000",
    "number": "1366824773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4201 1ST AVE SE",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524023144",
            "telephone_number": "319-364-7108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 1ST AVE SE",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524023144",
            "telephone_number": "319-364-7108",
            "fax_number": "319-364-6529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUGGIERO",
        "first_name": "PETER",
        "middle_name": "JOSEPH",
        "name_prefix": "Mr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-22",
        "last_updated": "2021-07-01",
        "certification_date": "2021-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IA",
            "license": "DDS-09218",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Rapids, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 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.

Verify at the official NPI Registry.