Active NPI
Jose Antonio Alcantara Ruiz, RDH
- Dental Hygienist
- Salem, OR
National Provider Identifier
1780342212
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- H8353
- Practice address
- 610 Hawthorne Ave SE
Salem, OR 97301-5859 - Phone
- (503) 585-5205
- NPI assigned
- Dec 1, 2021
- Last updated
- Dec 1, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | H8353 | OR | Primary |
Addresses
Primary practice location
610 Hawthorne Ave SE
Salem, OR 97301-5859
Mailing address
6732 SE 80TH Ave
Portland, OR 97206-7129
Phone (503) 847-6363
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
| License | State | Type | Specialty |
|---|---|---|---|
| H8353 | OR | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1638316800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1638316800000",
"number": "1780342212",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6732 SE 80TH AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972067129",
"telephone_number": "503-847-6363"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "610 HAWTHORNE AVE SE",
"city": "SALEM",
"state": "OR",
"postal_code": "973015859",
"telephone_number": "503-585-5205"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALCANTARA RUIZ",
"first_name": "JOSE ANTONIO",
"credential": "RDH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-12-01",
"last_updated": "2021-12-01",
"certification_date": "2021-12-01",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "OR",
"license": "H8353",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Salem, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.