Provider Demographics
NPI:1194367623
Name:JAFFER, RUHEE (DDS)
Entity Type:Individual
Prefix:
First Name:RUHEE
Middle Name:
Last Name:JAFFER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:912 N SAN VICENTE BLVD APT 1
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90069-3890
Mailing Address - Country:US
Mailing Address - Phone:703-994-0518
Mailing Address - Fax:
Practice Address - Street 1:900 N LA BREA AVE STE 5
Practice Address - Street 2:
Practice Address - City:WEST HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:90038-2322
Practice Address - Country:US
Practice Address - Phone:703-994-0518
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-16
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014167231223G0001X
CA1060211223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice