Individual provider Active NPI

Adrian Ramsey Ruiz, DDS

  • General Practice Dentistry
  • Long Beach, CA
National Provider Identifier
1477564284
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
42768 Issued in CA
Practice address
1729 Termino Ave
Long Beach, CA 90804-2121
Phone
(562) 494-8400
Fax
(562) 494-8412
NPI assigned
Aug 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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 42768 CA Primary

Addresses

Primary practice location

1729 Termino Ave
Long Beach, CA 90804-2121

Mailing address

1729 Termino Ave
Long Beach, CA 90804-2121
Phone (562) 494-8400

Other identifiers 1

IdentifierTypeStateIssuer
G93855-01MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20151231000305 CA Order and Referring Only - DentistPractitioner - Dentist 1153623558

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
42768CAMDGeneral Practice Dentistry
4278CAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Radiant Smiles Series 8 LLC CurrentSince Apr 27, 2025 Accepting new patients
Beautiful Smiles General Practice Past Accepting new patients

Locations

5095 Blue Diamond Rd
Ste 105
Las Vegas, NV 89139
Phone (702) 970-0512

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": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1477564284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1729 TERMINO AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908042121",
            "telephone_number": "562-494-8400",
            "fax_number": "562-494-8412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1729 TERMINO AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908042121",
            "telephone_number": "562-494-8400",
            "fax_number": "562-494-8412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUIZ",
        "first_name": "ADRIAN",
        "middle_name": "RAMSEY",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-10",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "42768",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "G93855-01",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.