Active NPI
Manuel Arturo Gonzalez Ruiz Jr., DDS
- Public Health Dentistry
- San Diego, CA
National Provider Identifier
1598545121
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Public Health Dentistry
- License
- 109538
- Practice address
- 3170 Clairemont Dr
San Diego, CA 92117-6411 - Phone
- (619) 907-7918
- NPI assigned
- Oct 2, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Public Health Dentistry | 1223D0001X | 109538 | CA | Primary |
Addresses
Primary practice location
3170 Clairemont Dr
San Diego, CA 92117-6411
Mailing address
3170 Clairemont Dr
San Diego, CA 92117-6411
Phone (619) 907-7918
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 109538 | Medicaid | CA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 109538 | CA | MD | Public Health Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1696204800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1696204800000",
"number": "1598545121",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3170 CLAIREMONT DR",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921176411",
"telephone_number": "619-907-7918"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3170 CLAIREMONT DR",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921176411",
"telephone_number": "619-907-7918"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONZALEZ RUIZ",
"first_name": "MANUEL",
"middle_name": "ARTURO",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-10-02",
"last_updated": "2023-10-02",
"certification_date": "2023-10-02",
"status": "A"
},
"taxonomies": [
{
"code": "1223D0001X",
"taxonomy_group": "",
"desc": "Dentist, Dental Public Health",
"state": "CA",
"license": "109538",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "109538",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.