Provider Demographics
NPI:1922703248
Name:INSPIRE KIDS DENTAL PLLC
Entity Type:Organization
Organization Name:INSPIRE KIDS DENTAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:RUMINSON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:423-910-9778
Mailing Address - Street 1:5913 MAIN ST STE 101
Mailing Address - Street 2:
Mailing Address - City:OOLTEWAH
Mailing Address - State:TN
Mailing Address - Zip Code:37363-7832
Mailing Address - Country:US
Mailing Address - Phone:909-255-9362
Mailing Address - Fax:
Practice Address - Street 1:5913 MAIN ST STE 101
Practice Address - Street 2:
Practice Address - City:OOLTEWAH
Practice Address - State:TN
Practice Address - Zip Code:37363-7832
Practice Address - Country:US
Practice Address - Phone:909-255-9362
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-04
Last Update Date:2024-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty