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 1:1021 S PARK RD APT 109
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-8767
Mailing Address - Country:US
Mailing Address - Phone:786-600-8651
Mailing Address - Fax:
Practice Address - Street 1:4440 SHERIDAN ST STE C
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-3535
Practice Address - Country:US
Practice Address - Phone:954-882-0191
Practice Address - Fax:754-210-3962
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-25
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN29076122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist