Provider Demographics
NPI:1447094255
Name:RUIZ ORTEGA, YOEL (DMD)
Entity type:Individual
Prefix:DR
First Name:YOEL
Middle Name:
Last Name:RUIZ ORTEGA
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:306 SW 19TH ST
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33991-3711
Mailing Address - Country:US
Mailing Address - Phone:786-600-8651
Mailing Address - Fax:
Practice Address - Street 1:4125 CLEVELAND AVE
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33901-9046
Practice Address - Country:US
Practice Address - Phone:239-939-9050
Practice Address - Fax:239-939-9054
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-25
Last Update Date:2025-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN29076122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist