Provider Demographics
NPI:1487661369
Name:RUEB, STEVE A (DDS)
Entity Type:Individual
Prefix:MR
First Name:STEVE
Middle Name:A
Last Name:RUEB
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1125 GRAND BLVD
Mailing Address - Street 2:SUITE 1313
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64106
Mailing Address - Country:US
Mailing Address - Phone:816-842-8180
Mailing Address - Fax:816-842-8180
Practice Address - Street 1:1125 GRAND BLVD
Practice Address - Street 2:SUITE 1313
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64106
Practice Address - Country:US
Practice Address - Phone:816-842-8180
Practice Address - Fax:816-842-8180
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO141121223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO11101015OtherBLUE CROSS BLUE SHIELD