Jeffrey A Ruttencutter, DDS PHD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019.028273 Issued in IL

Practice address

80 N Northwest Hwy
Park Ridge, IL 60068

Phone

(847) 292-0600

NPI assigned

May 18, 2010

Last updated

Apr 24, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective May 4, 2016 through May 4, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Chang Ruttencutter PC

  dba Uptown Dentistry of Morton Grove

  • General Practice Dentistry
  • Morton Grove, IL
  • NPI 1336954502
  NPD Authorized official
• Ruttencutter Chang, PC

  dba Uptown Dentistry

  • Dentist
  • Park Ridge, IL
  • NPI 1275828360
  NPD (past) Authorized official

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

{
    "created_epoch": "1274140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335225600000",
    "number": "1770802688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 N NORTHWEST HWY",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "60068",
            "telephone_number": "847-292-0600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 N NORTHWEST HWY",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "60068",
            "telephone_number": "847-292-0600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUTTENCUTTER",
        "first_name": "JEFFREY",
        "middle_name": "A",
        "credential": "DDS PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-05-18",
        "last_updated": "2012-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019.028273",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John William Runne, DO
• Rush-Select Holdings, LLC. (RUSH Physical Therapy)
• Cody Nathaniel Russell, MD
• Michael J Russell II
• Ruttencutter Chang, PC (Uptown Dentistry)
• George Walter Rybak Jr. Jr., D.C.
• Constance E Ryjewski, APN-CNS
• Moustafa Nagi Sabri, MD
• Katarzyna Sacha, PT
• Aaron Lowell Sackschewsky

• General Practice Dentistry in Park Ridge, IL
• Providers in Park Ridge, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.