Individual provider Active NPI

Fernando Daniel Ruiz, DDS

  • Dentist
  • Cedar Park, TX
National Provider Identifier
1770001562
Registry record updated Jun 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
33745 Issued in TX
Practice address
2800 E Whitestone Blvd Ste 225
Cedar Park, TX 78613-7276
Phone
(512) 337-0993
NPI assigned
Sep 1, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 12014023A IN
Dentist 122300000X 33745 TX Primary

Addresses

Primary practice location

2800 E Whitestone Blvd Ste 225
Cedar Park, TX 78613-7276

Mailing address

14911 Sr 23
Granger, IN 46530
Phone (574) 221-8841

Other identifiers 1

IdentifierTypeStateIssuer
33745MedicaidTX

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

LicenseStateTypeSpecialty
33745TXMDDentist
12014023AINMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Ron C Abaro DDS PC Dentist CurrentSince Jun 25, 2023 Accepting new patients
Market Street Family Dental,PLLC General Practice PastSince Jul 24, 2022 Accepting new patients

Locations

14911 State Road 23
Granger, IN 46530
Phone (574) 221-8841

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.

NPI Registry JSON

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

{
    "created_epoch": "1504224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687219200000",
    "number": "1770001562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14911 SR 23",
            "city": "GRANGER",
            "state": "IN",
            "postal_code": "46530",
            "telephone_number": "574-221-8841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 E WHITESTONE BLVD STE 225",
            "city": "CEDAR PARK",
            "state": "TX",
            "postal_code": "786137276",
            "telephone_number": "512-337-0993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUIZ",
        "first_name": "FERNANDO",
        "middle_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-01",
        "last_updated": "2023-06-20",
        "certification_date": "2023-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12014023A",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "33745",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33745",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Park, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2023; 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.