Jennifer Patricia Rueda, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

DN27460 Issued in FL

Practice address

120 Carter Blvd Ste 7
Polk City, FL 33868-8912

Phone

(863) 984-0000

NPI assigned

Jan 24, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Artistic Dental of Polk City, LLC

  • Dental Clinic/Center
  • Polk City, FL
  • NPI 1528301058
  NPD (past)
• Kreative Dental Care PA

  • Dental Clinic/Center
  • Polk City, FL
  • NPI 1861967333
  NPD (past)

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

{
    "created_epoch": "1674518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674518400000",
    "number": "1962118992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 CALLAWALK CT APT 302",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "338965554",
            "telephone_number": "786-955-5507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 CARTER BLVD STE 7",
            "city": "POLK CITY",
            "state": "FL",
            "postal_code": "338688912",
            "telephone_number": "863-984-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUEDA",
        "first_name": "JENNIFER",
        "middle_name": "PATRICIA",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-01-24",
        "last_updated": "2023-01-24",
        "certification_date": "2023-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN27460",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "kreativedentalcare@gmail.com",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "120 Carter Blvd Ste 7",
            "city": "Polk City",
            "state": "FL",
            "country_code": "US",
            "postal_code": "338688912",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Diego Ramirez, ATC, LAT, LMT.
• Rapid Speech Therapy LLC
• Beverly Reaves, RN
• Karen Maria Rivero
• Dayanara Rodriguez Muniz
• Odette V Sanchez Moreno
• Viviana A Schmidt
• Rema Sheikah
• Social Work Consultant Services
• Jaime Stewart

• Dentist in Polk City, FL
• Providers in Polk City, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2023; 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.