Active NPI
Juan Ruiz
- Dentist
- Chicago, IL
National Provider Identifier
1841004751
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 019036494
- Practice address
- 3924 S Archer Ave Ste D
Chicago, IL 60632-1193 - Phone
- (773) 819-7101
- NPI assigned
- Feb 3, 2025
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 019036494 | IL | Primary |
Addresses
Primary practice location
3924 S Archer Ave Ste D
Chicago, IL 60632-1193
Mailing address
635 Albany St
Boston, MA 02118-3550
Phone (617) 358-8300
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 |
|---|---|---|---|
| 019036494 | IL | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1738540800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1759104000000",
"number": "1841004751",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "635 ALBANY ST",
"city": "BOSTON",
"state": "MA",
"postal_code": "021183550",
"telephone_number": "617-358-8300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3924 S ARCHER AVE STE D",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606321193",
"telephone_number": "773-819-7101"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUIZ",
"first_name": "JUAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-02-03",
"last_updated": "2025-09-29",
"certification_date": "2025-09-29",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IL",
"license": "019036494",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.