Individual provider Active NPI

Ruby Estelle Fifer, DDS

  • General Practice Dentistry
  • Toledo, OH
National Provider Identifier
1467401190
Registry record updated Dec 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
30-015959 Issued in OH
Practice address
1520 Broadway St
Toledo, OH 43609-2855
Phone
(419) 255-9000
NPI assigned
May 9, 2006
Last updated
Dec 28, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2010

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 30-015959 OH Primary

Addresses

Primary practice location

1520 Broadway St
Toledo, OH 43609-2855

Mailing address

201 W 8TH St
Suite 810
Pueblo, CO 81003-3038
Phone (719) 562-4447

Other identifiers 2

IdentifierTypeStateIssuer
0514330MedicaidOH
9175722OtherOHDORAL

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)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Small Smiles of Toledo, LLC General Practice Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1147132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1293494400000",
    "number": "1467401190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 W 8TH ST",
            "address_2": "SUITE 810",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810033038",
            "telephone_number": "719-562-4447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 BROADWAY ST",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436092855",
            "telephone_number": "419-255-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIFER",
        "first_name": "RUBY",
        "middle_name": "ESTELLE",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-09",
        "last_updated": "2010-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30-015959",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0514330",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DORAL",
            "identifier": "9175722",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2010; 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.