Provider Demographics
NPI:1710030804
Name:RUIZ, MARIA VICTORIA MEDIRAN (DDS)
Entity Type:Individual
Prefix:
First Name:MARIA VICTORIA
Middle Name:MEDIRAN
Last Name:RUIZ
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 1:180 E EL MONTE WAY
Mailing Address - Street 2:SUITE 102
Mailing Address - City:DINUBA
Mailing Address - State:CA
Mailing Address - Zip Code:93618-1551
Mailing Address - Country:US
Mailing Address - Phone:559-591-7188
Mailing Address - Fax:
Practice Address - Street 1:180 E EL MONTE WAY
Practice Address - Street 2:SUITE 102
Practice Address - City:DINUBA
Practice Address - State:CA
Practice Address - Zip Code:93618-1551
Practice Address - Country:US
Practice Address - Phone:559-591-7188
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-19
Last Update Date:2020-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAB442521223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice