Provider Demographics
NPI:1700194289
Name:RUIZ, SONYA RENEE (DDS)
Entity Type:Individual
Prefix:DR
First Name:SONYA
Middle Name:RENEE
Last Name:RUIZ
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:SONYA
Other - Middle Name:RENEE
Other - Last Name:RUIZ-SEDILLO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:8490 S EASTERN AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89123-2805
Mailing Address - Country:US
Mailing Address - Phone:702-914-0000
Mailing Address - Fax:702-914-5872
Practice Address - Street 1:8490 S EASTERN AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89123-2805
Practice Address - Country:US
Practice Address - Phone:702-914-0000
Practice Address - Fax:702-914-5872
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-19
Last Update Date:2010-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV3195122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist