Provider Demographics
NPI:1619985322
Name:RUBY, SARA (DMD)
Entity Type:Individual
Prefix:DR
First Name:SARA
Middle Name:
Last Name:RUBY
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 WEXFORD BAYNE RD STE 200
Mailing Address - Street 2:
Mailing Address - City:WEXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15090-8790
Mailing Address - Country:US
Mailing Address - Phone:412-538-0010
Mailing Address - Fax:412-538-0012
Practice Address - Street 1:171 WEXFORD BAYNE RD STE 200
Practice Address - Street 2:
Practice Address - City:WEXFORD
Practice Address - State:PA
Practice Address - Zip Code:15090-8790
Practice Address - Country:US
Practice Address - Phone:412-538-0010
Practice Address - Fax:412-538-0010
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2021-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS-036351122300000X, 1223P0221X
OH30-0221521223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice