Samantha Jean Ruiz, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

6544-15 Issued in WI

Practice address

1300 N Summit Ave Ste 101
Oconomowoc, WI 53066-4467

Phone

(262) 567-1323

NPI assigned

Jun 4, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Samantha Jean Olbrys Former name

Medicare fee-for-service enrollment

Enrolled in WI

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

Medicare enrollment (NPD)

Enrolled

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.

• Lakeland Family Dental, LLC

  • Dentist
  • Oconomowoc, WI
  • NPI 1518418243
  NPD (past) Authorized official
• Sheild Family Dentistry, S.C.

  • General Practice Dentistry
  • Oconomowoc, WI
  • NPI 1346460649
  NPD (past)
• Showalter, Inc

  • General Practice Dentistry
  • Fort Atkinson, WI
  • NPI 1508187758
  NPD (past)

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

{
    "created_epoch": "1275609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559347200000",
    "number": "1508186263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 N SUMMIT AVE STE 101",
            "city": "OCONOMOWOC",
            "state": "WI",
            "postal_code": "530664467",
            "telephone_number": "262-567-1323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 N SUMMIT AVE STE 101",
            "city": "OCONOMOWOC",
            "state": "WI",
            "postal_code": "530664467",
            "telephone_number": "262-567-1323"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1951 Commerce Pkwy",
            "address_purpose": "LOCATION",
            "city": "Fort Atkinson",
            "state": "WI",
            "postal_code": "535383139",
            "country_code": "US",
            "telephone_number": "920-563-4415",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUIZ",
        "first_name": "SAMANTHA",
        "middle_name": "JEAN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-04",
        "last_updated": "2019-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "6544-15",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAMANTHA",
            "last_name": "OLBRYS",
            "middle_name": "JEAN",
            "prefix": "DR.",
            "credential": "D.D.S.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Roundys Supermarkets Inc
• Roundys Supermarkets Inc
• Angelica M Rowin-Fox, FNP
• Kim R. Ruffalo, OTR, CLT-LANA
• Thomas Ruffalo, PA
• Joan Carol Russo, PH.D.
• Jeffrey Daniel Rutkowski, D.C.
• Jan E Rutledge, RN
• M Fay Sanders, LCSW
• Sarah Jean Sanford-Smith, MSN FNP-C

• Dentist in Oconomowoc, WI
• Providers in Oconomowoc, WI by specialty
• Dentist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.