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General NPI Number Information
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NPI Number | 1649889692
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Entity Type | Individual
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Provider Name | RUCHI JAIN DDS
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Gender | Female
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Dates
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Enumeration Date | 07/27/2020
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Last Update Date | 10/27/2021
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Provider Practice Location Address
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Address Line | 859 E NORTH CREEK DR
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City | SHERMAN
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State | TX
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Zip | 75092-4064
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Country | US
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Telephone | 903-686-1897
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Fax |
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Provider Business Mailing Address
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Address Line | 417 ADVENTUROUS SHIELD DR
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City | LEWISVILLE
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State | TX
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Zip | 75056-5409
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Country | US
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Telephone | 408-887-4100
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 36418
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 36418
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License Number State | TX
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