Provider Demographics
NPI:1497895957
Name:RUVO, JANIS A (DMD)
Entity Type:Individual
Prefix:DR
First Name:JANIS
Middle Name:A
Last Name:RUVO
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:171 RIDGEDALE AVE
Mailing Address - Street 2:ANNEX, SUITE L
Mailing Address - City:FLORHAM PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07932-1764
Mailing Address - Country:US
Mailing Address - Phone:973-301-2223
Mailing Address - Fax:973-301-2229
Practice Address - Street 1:171 RIDGEDALE AVE
Practice Address - Street 2:ANNEX, SUITE L
Practice Address - City:FLORHAM PARK
Practice Address - State:NJ
Practice Address - Zip Code:07932-1764
Practice Address - Country:US
Practice Address - Phone:973-301-2223
Practice Address - Fax:973-301-2229
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ151821223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice