Individual provider Active NPI

Jonathan William Ruminson, D.D.S.

  • Dentist
  • Ooltewah, TN
National Provider Identifier
1871963090
Registry record updated Feb 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
65113 Issued in CA
Practice address
5913 Main St Ste 101
Ooltewah, TN 37363-7832
Phone
(423) 910-9778
NPI assigned
Sep 30, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 65113 CA Primary

Addresses

Primary practice location

5913 Main St Ste 101
Ooltewah, TN 37363-7832

Mailing address

5913 Main St Ste 101
Ooltewah, TN 37363-7832
Phone (423) 910-9778

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

Practice roles

OrganizationSpecialtyStatusNew patients
Inspire Kids Dental PLLC CurrentSince Apr 9, 2023 Accepting new patients

Locations

5913 Main St
Ste 101
Ooltewah, TN 37363
Phone (423) 362-7962

Organizations & group practices 1

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": "1443571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707004800000",
    "number": "1871963090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5913 MAIN ST STE 101",
            "city": "OOLTEWAH",
            "state": "TN",
            "postal_code": "373637832",
            "telephone_number": "423-910-9778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5913 MAIN ST STE 101",
            "city": "OOLTEWAH",
            "state": "TN",
            "postal_code": "373637832",
            "telephone_number": "423-910-9778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUMINSON",
        "first_name": "JONATHAN",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-09-30",
        "last_updated": "2024-02-04",
        "certification_date": "2024-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "65113",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ooltewah, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2024; 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.