Active NPI
Melissa Ruiz
- Dentist
- Phoenix, AZ
National Provider Identifier
1609484997
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- D012338
- Practice address
- 2827 W Peoria Ave Ste 101
Phoenix, AZ 85029-5213 - Phone
- (928) 482-3614
- NPI assigned
- Jul 22, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DN25208 | FL | |
| Dentist | 122300000X | D012338 | AZ | Primary |
Addresses
Primary practice location
2827 W Peoria Ave Ste 101
Phoenix, AZ 85029-5213
Mailing address
PO Box 566283
Miami, FL 33256-6283
Phone (305) 798-7677
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 |
|---|---|---|---|
| D012338 | AZ | MD | Dentist |
| DN25208 | FL | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brell Dental PLLC | General Practice | Past | Accepting new patients |
| Flo City Dental LLC | General Practice | Past | Accepting new patients |
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.
-
- General Practice Dentistry
- Altamonte Springs, FL
- NPI 1144941311
-
- General Practice Dentistry
- Florida City, FL
- NPI 1942952676
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1595376000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1729555200000",
"number": "1609484997",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 566283",
"city": "MIAMI",
"state": "FL",
"postal_code": "332566283",
"telephone_number": "305-798-7677"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2827 W PEORIA AVE STE 101",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850295213",
"telephone_number": "928-482-3614"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUIZ",
"first_name": "MELISSA",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-07-22",
"last_updated": "2024-10-22",
"certification_date": "2024-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "FL",
"license": "DN25208",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "AZ",
"license": "D012338",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.