Provider Demographics
NPI:1033287016
Name:RUVINS, EDWARD (DDS MS)
Entity Type:Individual
Prefix:
First Name:EDWARD
Middle Name:
Last Name:RUVINS
Suffix:
Gender:M
Credentials:DDS MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6630 E HAMPDEN AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80224-3004
Mailing Address - Country:US
Mailing Address - Phone:720-934-1122
Mailing Address - Fax:303-484-4024
Practice Address - Street 1:6630 E HAMPDEN AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80224-3004
Practice Address - Country:US
Practice Address - Phone:720-934-1122
Practice Address - Fax:303-484-4024
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-30
Last Update Date:2022-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO101YA0400X
CO7434122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral Practice
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No122300000XDental ProvidersDentistGroup - Multi-Specialty