Individual provider Active NPI

Jordana Leah Contrucci Ruiz, DMD

  • Dentist
  • Dallas, TX
National Provider Identifier
1902281678
Registry record updated Sep 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
31300 Issued in TX
Practice address
7777 Forest LN Ste C104
Dallas, TX 75230-6830
Phone
(972) 566-4990
Fax
(972) 566-4993
NPI assigned
Jul 23, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 31300 TX Primary

Addresses

Primary practice location

7777 Forest LN Ste C104
Dallas, TX 75230-6830

Mailing address

7777 Forest LN Ste C104
Dallas, TX 75230-6830
Phone (954) 562-2199

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
31300TXMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1437609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568419200000",
    "number": "1902281678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7777 FOREST LN STE C104",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752306830",
            "telephone_number": "954-562-2199",
            "fax_number": "972-566-4993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7777 FOREST LN STE C104",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752306830",
            "telephone_number": "972-566-4990",
            "fax_number": "972-566-4993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUIZ",
        "first_name": "JORDANA",
        "middle_name": "LEAH CONTRUCCI",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-23",
        "last_updated": "2019-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "31300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2019; 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.