Richard Edmund Ruder, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

DE61171119 Issued in WA

Practice address

150 W Sequim Bay Rd
Sequim, WA 98382-8406

Phone

(360) 565-5066

Fax

(360) 504-2237

NPI assigned

Jul 14, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Despain Boyack PLLC

  • General Practice Dentistry
  • Sequim, WA
  • NPI 1225619984
  NPD (past)

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

{
    "created_epoch": "1626220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626220800000",
    "number": "1427620863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 W SEQUIM BAY RD",
            "city": "SEQUIM",
            "state": "WA",
            "postal_code": "983828406",
            "telephone_number": "360-565-5066",
            "fax_number": "360-504-2237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 W SEQUIM BAY RD",
            "city": "SEQUIM",
            "state": "WA",
            "postal_code": "983828406",
            "telephone_number": "360-565-5066",
            "fax_number": "360-504-2237"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "321 N Sequim Ave Ste D",
            "address_purpose": "LOCATION",
            "city": "Sequim",
            "state": "WA",
            "postal_code": "983823686",
            "country_code": "US",
            "telephone_number": "360-683-5700",
            "fax_number": "360-683-7132",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUDER",
        "first_name": "RICHARD",
        "middle_name": "EDMUND",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-14",
        "last_updated": "2021-07-14",
        "certification_date": "2021-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE61171119",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTIST",
            "identifier": "DE61171119",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "olympicsmilecare@gmail.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "150 W Sequim Bay Rd",
            "city": "Sequim",
            "state": "WA",
            "country_code": "US",
            "postal_code": "983828406",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Katherine Nora Rook, DPT
• Diane H. Root-Racine, ARNP
• Janie Ross-Johnson, M.S.
• Kimberly Ann Rothwell, PHARMACIST
• Lemuel Dale Rudd, PT
• Jose Alberto Ruiz-Bonilla, M.D.
• Ryan Rudd DDS, Ms, PC
• Danyel Frances Ryan, LMP
• Patricia Ryan
• Safe Harbor Recovery Center - Sequim, Inc.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 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.