Provider Demographics
NPI:1497861850
Name:PANDEY, RUBY (DDS)
Entity Type:Individual
Prefix:MRS
First Name:RUBY
Middle Name:
Last Name:PANDEY
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 1:3646 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WHITEHALL
Mailing Address - State:OH
Mailing Address - Zip Code:43213-2913
Mailing Address - Country:US
Mailing Address - Phone:614-231-4800
Mailing Address - Fax:614-231-4801
Practice Address - Street 1:3646 E MAIN ST
Practice Address - Street 2:
Practice Address - City:WHITEHALL
Practice Address - State:OH
Practice Address - Zip Code:43213-2913
Practice Address - Country:US
Practice Address - Phone:614-231-4800
Practice Address - Fax:614-231-4801
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2007-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30022023122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2519902Medicaid