NPIMap

Organization Active NPI

Keith Ruter LLC Dba Riverside Dental

  • General Practice Dentistry
  • Savanna, IL
National Provider Identifier
1750640439
Registry record updated Oct 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019019570 Issued in IL
Legal business name
KEITH RUTER LLC DBA RIVERSIDE DENTAL
Practice address
401 Main St
Savanna, IL 61074-1535
Phone
(815) 273-2212
Fax
(815) 273-1081
NPI assigned
May 15, 2012
Last updated
Oct 29, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2013

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

Authorized official

Name
Dr. Keith R Ruter, DDS
Title
Owner
Phone
(815) 938-2566

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 019019570 IL Primary

Addresses

Primary practice location

401 Main St
Savanna, IL 61074-1535

Mailing address

401 Main St
Savanna, IL 61074-1535
Phone (815) 273-2212

National Provider Directory

National Provider Directory

Locations

401 Main St
Savanna, IL 61074
Phone (815) 273-2212

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1337040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383004800000",
    "number": "1750640439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 MAIN ST",
            "city": "SAVANNA",
            "state": "IL",
            "postal_code": "610741535",
            "telephone_number": "815-273-2212",
            "fax_number": "815-273-1081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 MAIN ST",
            "city": "SAVANNA",
            "state": "IL",
            "postal_code": "610741535",
            "telephone_number": "815-273-2212",
            "fax_number": "815-273-1081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEITH RUTER LLC DBA RIVERSIDE DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-15",
        "last_updated": "2013-10-29",
        "status": "A",
        "authorized_official_last_name": "RUTER",
        "authorized_official_first_name": "KEITH",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "815-938-2566",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019019570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Savanna, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2013; 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.