Individual provider Active NPI

Reuben Anthony Ramillosa, D.D.S.

  • General Practice Dentistry
  • Salem, OR
National Provider Identifier
1891796777
Registry record updated Jul 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D7662 Issued in OR
Practice address
128 Friendship Ave SE
Salem, OR 97302-5716
Phone
(503) 364-7812
Fax
(503) 540-5734
NPI assigned
Aug 2, 2005
Reactivated
Mar 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D7662 OR Primary

Addresses

Primary practice location

128 Friendship Ave SE
Salem, OR 97302-5716

Mailing address

128 Friendship Ave SE
Salem, OR 97302-5716
Phone (503) 364-7812

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
D7662ORMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
R. Anthony Ramillosa, DDS, PC General Practice CurrentSince Jul 22, 2025 Accepting new patients

Locations

128 Friendship Ave SE
Salem, OR 97302
Phone (503) 364-7812

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": "1122940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752624000000",
    "number": "1891796777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 FRIENDSHIP AVE SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973025716",
            "telephone_number": "503-364-7812",
            "fax_number": "503-540-5734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 FRIENDSHIP AVE SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973025716",
            "telephone_number": "503-364-7812",
            "fax_number": "503-540-5734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAMILLOSA",
        "first_name": "REUBEN",
        "middle_name": "ANTHONY",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-02",
        "last_updated": "2025-07-16",
        "certification_date": "2025-07-16",
        "deactivation_date": "2006-03-22",
        "reactivation_date": "2006-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D7662",
            "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 Jul 16, 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.

Verify at the official NPI Registry.