Individual provider Active NPI

Nimsy Ruiz, D.M.D.

  • General Practice Dentistry
  • Carolina, PR
National Provider Identifier
1639232705
Registry record updated Mar 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2669 Issued in PR
Practice address
Carolina Shopp Ctr Ste 311
Ave 65TH Inf Esq Roberto Clemente
Carolina, PR 00985-5672
Phone
(787) 512-0488
Fax
(787) 752-0332
NPI assigned
Dec 19, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2669 PR Primary

Addresses

Primary practice location

Carolina Shopp Ctr Ste 311
Ave 65TH Inf Esq Roberto Clemente
Carolina, PR 00985-5672

Mailing address

Las Haciendas 15043 Calle Camino Largo
Canovanas, PR 00729
Phone (787) 438-2186

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
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

Enrollment IDStateProvider typePAC IDDetails
I20240110003017 PR Order and Referring Only - DentistPractitioner - Dentist 5890084461

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2669PRMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458172800000",
    "number": "1639232705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "LAS HACIENDAS 15043 CALLE CAMINO LARGO",
            "city": "CANOVANAS",
            "state": "PR",
            "postal_code": "00729",
            "telephone_number": "787-438-2186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CAROLINA SHOPP CTR STE 311",
            "address_2": "AVE 65TH INF ESQ ROBERTO CLEMENTE",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "009855672",
            "telephone_number": "787-512-0488",
            "fax_number": "787-752-0332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUIZ",
        "first_name": "NIMSY",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-19",
        "last_updated": "2016-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PR",
            "license": "2669",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carolina, PR

Sources for this page

Verify at the official NPI Registry.