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General NPI Number Information
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NPI Number | 1750404125
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Entity Type | Organization
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Legal Business Name | JARED W. RUMINSON, DDS
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Dates
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Enumeration Date | 04/09/2007
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Last Update Date | 12/10/2013
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Provider Practice Location Address
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Address Line | 993 GOVERNOR DR STE 104
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City | EL DORADO HILLS
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State | CA
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Zip | 95762-4231
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Country | US
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Telephone | 916-941-1515
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Fax | 916-941-0505
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Provider Business Mailing Address
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Address Line | 993 GOVERNOR DR STE 104
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City | EL DORADO HILLS
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State | CA
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Zip | 95762-4231
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Country | US
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Telephone | 916-941-1515
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Fax | 916-941-0505
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Authorized Official
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Title or Position | OWNER
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Name | DR. JARED W. RUMINSON
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Credential | D.D.S.
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Telephone | 916-941-1515
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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 | 45317
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License Number State | CA
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