Healthcare Provider Details
I. General information
NPI: 1902655525
Provider Name (Legal Business Name): RUTH UMOREN DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 05/15/2024
Last Update Date: 06/20/2025
Certification Date: 06/20/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1103 S JOSEY LN STE 706-707
CARROLLTON TX
75006-7680
US
IV. Provider business mailing address
5800 N I 35 STE 205
DENTON TX
76207-1438
US
V. Phone/Fax
- Phone: 214-509-7778
- Fax:
- Phone: 940-220-7833
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 390200000X |
| Taxonomy | Student in an Organized Health Care Education/Training Program |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1223G0001X |
| Taxonomy | General Practice Dentistry |
| License Number | 40900 |
| License Number State | TX |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: