Individual provider Active NPI

Eliseo Ruiz, D.M.D

  • General Practice Dentistry
  • Miami, FL
National Provider Identifier
1457589525
Registry record updated Jun 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN18793 Issued in FL
Practice address
8221 W Flagler St
Miami, FL 33144-2027
Phone
(305) 266-7000
Fax
(305) 261-0397
NPI assigned
Jun 29, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 29, 2009

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 DN18793 FL Primary

Addresses

Primary practice location

8221 W Flagler St
Miami, FL 33144-2027

Mailing address

6915 Main St Apt 333
Miami Lakes, FL 33014-7007
Phone (786) 262-0175

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20170211000048 FL Order and Referring Only - DentistPractitioner - Dentist 6103109491

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN18793FLMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Modern Dental by Smile, PA General Practice Past Accepting new patients
Modern Dental Center, PA Past Accepting new patients

Organizations & group practices 2

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": "1246233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1246233600000",
    "number": "1457589525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6915 MAIN ST APT 333",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330147007",
            "telephone_number": "786-262-0175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8221 W FLAGLER ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331442027",
            "telephone_number": "305-266-7000",
            "fax_number": "305-261-0397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUIZ",
        "first_name": "ELISEO",
        "credential": "D.M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-06-29",
        "last_updated": "2009-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN18793",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.