Individual provider Active NPI

Eric F Ruiz, DDS

  • General Practice Dentistry
  • Avon, CT
National Provider Identifier
1457561102
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
011111 Issued in CT
Practice address
44 Dale Rd
Avon, CT 06001-4315
Phone
(860) 677-6405
NPI assigned
May 23, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 011111 CT Primary

Addresses

Primary practice location

44 Dale Rd
Avon, CT 06001-4315

Mailing address

10 Cobble CT
Unionville, CT 06085-1593
Phone (860) 839-2744

Other practice location 1

University Of Connecticut Health Ctr
263 Farmington ave
Farmington, CT 06030-0001
Phone (860) 679-4920

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20150203000179 CT Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 6608191242

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
011111CTMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1457561102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 COBBLE CT",
            "city": "UNIONVILLE",
            "state": "CT",
            "postal_code": "060851593",
            "telephone_number": "860-839-2744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44 DALE RD",
            "city": "AVON",
            "state": "CT",
            "postal_code": "060014315",
            "telephone_number": "860-677-6405"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "University Of Connecticut Health Ctr",
            "address_2": "263 Farmington ave",
            "address_purpose": "LOCATION",
            "city": "Farmington",
            "state": "CT",
            "postal_code": "060300001",
            "country_code": "US",
            "telephone_number": "860-679-4920",
            "fax_number": "860-679-1899",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUIZ",
        "first_name": "ERIC",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-23",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "011111",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Avon, CT

Sources for this page

Verify at the official NPI Registry.