Healthcare Provider Details

I. General information

NPI: 1154388098
Provider Name (Legal Business Name): AARON RUSKIN DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2006
Last Update Date: 07/13/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32905 W 12 MILE RD #200
FARMINGTON HILLS MI
48334-3342
US

IV. Provider business mailing address

22930 MAPLE ST
FARMINGTON MI
48336-3955
US

V. Phone/Fax

Practice location:
  • Phone: 248-553-3280
  • Fax: 248-553-2913
Mailing address:
  • Phone: 248-615-4186
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number2901017975
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: