MEDICARE: RUWAYDA MALIM RDH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	124Q00000X	Dental Hygienist	H12116	MN

General Provider Information

NPI Number	:	1649107798
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RUWAYDA MALIM RDH

Provider Business Mailing Address
First Line	:	3220 OAKLAND AVE
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55407-2004
Country	:	US
Telephone Number	:	612-426-0584
Fax Number	:

Provider Business Practice Location Address
First Line	:	4601 BLOOMINGTON AVE
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55407-3662
Country	:	US
Telephone Number	:	612-886-3270
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/05/2026
Last Update Date	:	05/05/2026

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