Individual provider Active NPI

Gary J Ruth, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • New York, NY
National Provider Identifier
1639265317
Registry record updated Jan 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
038254 Issued in NY
Practice address
30 East 60TH Street
Suite 1401
New York, NY 10022
Phone
(212) 832-1652
Fax
(212) 644-8266
NPI assigned
Oct 4, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 038254 NY Primary

Addresses

Primary practice location

30 East 60TH Street
Suite 1401
New York, NY 10022

Mailing address

30 East 60TH Street
Suite 1401
New York, NY 10022
Phone (212) 832-1652

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161027002009 NY Order and Referring Only - Maxillofacial SurgeryPractitioner - Maxillofacial Surgery 1052592185

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704240000000",
    "number": "1639265317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 EAST 60TH STREET",
            "address_2": "SUITE 1401",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10022",
            "telephone_number": "212-832-1652",
            "fax_number": "212-644-8266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 EAST 60TH STREET",
            "address_2": "SUITE 1401",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10022",
            "telephone_number": "212-832-1652",
            "fax_number": "212-644-8266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUTH",
        "first_name": "GARY",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2024-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "038254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.