Provider Demographics
NPI:1801058813
Name:NOVOTNY, RUMA RANI (DDS)
Entity type:Individual
Prefix:DR
First Name:RUMA
Middle Name:RANI
Last Name:NOVOTNY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:RUMA
Other - Middle Name:
Other - Last Name:SAHA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:1653 E. 2ND ST
Mailing Address - Street 2:
Mailing Address - City:CASPER
Mailing Address - State:WY
Mailing Address - Zip Code:82601
Mailing Address - Country:US
Mailing Address - Phone:307-234-6033
Mailing Address - Fax:307-234-6053
Practice Address - Street 1:1653 E. 2ND ST
Practice Address - Street 2:
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82601
Practice Address - Country:US
Practice Address - Phone:307-234-6033
Practice Address - Fax:307-234-6053
Is Sole Proprietor?:No
Enumeration Date:2008-06-30
Last Update Date:2020-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY1263122300000X, 1223G0001X
TX23906122300000X, 1223G0001X
CO10267122300000X, 1223G0001X
WY#12631223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist