NPIMap

Individual provider Active NPI

Jae Il Ru, DMD

  • General Practice Dentistry
  • Gambrills, MD
National Provider Identifier
1528638384
Registry record updated Jun 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
18551 Issued in MD
Practice address
325 Gambrills Rd Ste C
Gambrills, MD 21054-1102
Phone
(410) 923-0373
NPI assigned
Jun 24, 2021
Last updated
Jun 17, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 016.0134023 VT
General Practice Dentistry 1223G0001X 04711 NH
General Practice Dentistry 1223G0001X 18551 MD Primary

Addresses

Primary practice location

325 Gambrills Rd Ste C
Gambrills, MD 21054-1102

Mailing address

325 Gambrills Rd Ste C
Gambrills, MD 21054-1102
Phone (410) 923-0373

Other practice location 1

13 Town West Rd
Plymouth, NH 03264-3428
Phone (603) 728-4379

Other practice location 2

11 Dunning St Ste 3
Claremont, NH 03743-2045
Phone (603) 542-2351

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
18551MDMDClinical Social Worker
04711NHMDGeneral Practice Dentistry
016.0134023VTMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Dunning Dental Practice, Incorporated General Practice Past Accepting new patients
True Point Dental-Claremont, PLLC PastSince Sep 24, 2023 Accepting new patients
Hanover Road Dental Health, PA General Practice PastSince Feb 1, 2022 Accepting new patients
Hyland Dental, PC PastSince Feb 1, 2022 Accepting new patients
True Point Dental-NH, PLLC PastSince Jun 1, 2021 Accepting new patients
True Point Dental, PLLC PastSince Aug 29, 2021 Accepting new patients
Praveen Mandera DMD PC General Practice PastSince Jan 1, 2024 Accepting new patients
DRS Leary , Burroughs and Woods, L.L.C. General Practice PastSince Jun 23, 2025 Accepting new patients

Organizations & group practices 8

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": "1624492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750118400000",
    "number": "1528638384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 GAMBRILLS RD STE C",
            "city": "GAMBRILLS",
            "state": "MD",
            "postal_code": "210541102",
            "telephone_number": "410-923-0373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 GAMBRILLS RD STE C",
            "city": "GAMBRILLS",
            "state": "MD",
            "postal_code": "210541102",
            "telephone_number": "410-923-0373"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13 Town West Rd",
            "address_purpose": "LOCATION",
            "city": "Plymouth",
            "state": "NH",
            "postal_code": "032643428",
            "country_code": "US",
            "telephone_number": "603-728-4379",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11 Dunning St Ste 3",
            "address_purpose": "LOCATION",
            "city": "Claremont",
            "state": "NH",
            "postal_code": "037432045",
            "country_code": "US",
            "telephone_number": "603-542-2351",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RU",
        "first_name": "JAE IL",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-24",
        "last_updated": "2025-06-17",
        "certification_date": "2025-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VT",
            "license": "016.0134023",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NH",
            "license": "04711",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "18551",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gambrills, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2025; 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.