Provider Demographics
NPI:1730126020
Name:RAPUANO, RONALD JAMES (DMD)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:JAMES
Last Name:RAPUANO
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:385 S MAPLE AVE
Mailing Address - Street 2:SUITE 207
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07452-1543
Mailing Address - Country:US
Mailing Address - Phone:201-444-5355
Mailing Address - Fax:201-444-5502
Practice Address - Street 1:385 S MAPLE AVE
Practice Address - Street 2:SUITE 207
Practice Address - City:RIDGEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07452-1543
Practice Address - Country:US
Practice Address - Phone:201-444-5355
Practice Address - Fax:201-444-5502
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-02
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI009278001223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJT99490Medicare UPIN