Organization Active NPI

Ronald L Rumbaugh DDS PC

  • General Practice Dentistry
  • Fort Wayne, IN
National Provider Identifier
1578959375
Registry record updated Apr 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12008140A Issued in IN
Legal business name
RONALD L RUMBAUGH DDS PC
Practice address
10506 Coldwater Rd
Fort Wayne, IN 46845-1235
Phone
(260) 637-6976
Fax
(260) 637-6976
NPI assigned
Apr 9, 2015
Last updated
Apr 9, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2015

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

Authorized official

Name
Dr. Ronald Lee Rumbaugh, DDS
Title
President
Phone
(260) 637-6976

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 12008140A IN Primary

Addresses

Primary practice location

10506 Coldwater Rd
Fort Wayne, IN 46845-1235

Mailing address

10506 Coldwater Rd
Fort Wayne, IN 46845-1235
Phone (260) 637-6976

Other identifiers 1

IdentifierTypeStateIssuer
100055440AMedicaidIN

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1428537600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1428537600000",
    "number": "1578959375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10506 COLDWATER RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451235",
            "telephone_number": "260-637-6976",
            "fax_number": "260-637-6976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10506 COLDWATER RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451235",
            "telephone_number": "260-637-6976",
            "fax_number": "260-637-6976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RONALD L RUMBAUGH DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-09",
        "last_updated": "2015-04-09",
        "status": "A",
        "authorized_official_last_name": "RUMBAUGH",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "260-637-6976",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12008140A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100055440A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2015; 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.