Individual provider Active NPI

John Edward Rutledge

  • General Practice Dentistry
  • San Antonio, TX
National Provider Identifier
1669304424
Registry record updated Jul 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
42675 Issued in TX
Practice address
7511 S New Braunfels Ste 105
San Antonio, TX 78235-1074
Phone
(503) 616-8816
NPI assigned
Jun 3, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2026

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 42675 TX Primary

Addresses

Primary practice location

7511 S New Braunfels Ste 105
San Antonio, TX 78235-1074

Mailing address

14297 SW Walnut LN
Tigard, OR 97223-2092
Phone (503) 616-8816

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

NPI Registry JSON

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

{
    "created_epoch": "1780444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783728000000",
    "number": "1669304424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14297 SW WALNUT LN",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972232092",
            "telephone_number": "503-616-8816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7511 S NEW BRAUNFELS STE 105",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782351074",
            "telephone_number": "503-616-8816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUTLEDGE",
        "first_name": "JOHN",
        "middle_name": "EDWARD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-06-03",
        "last_updated": "2026-07-11",
        "certification_date": "2026-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "42675",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2026; 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.