Marangely Ruiz Medina
Dentist, Endodontics in Lake Mary, FL. Individual provider (NPI-1).
NPI number1366070195
StatusActive
Last updated in NPPESJul 12, 2025
Details
- NPI
- 1366070195
- Entity type
- Individual (NPI-1)
- Name
- Marangely Ruiz Medina
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Mar 28, 2020
- Certification date
- Jul 12, 2025
- Last updated
- Jul 12, 2025
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · ORDER AND REFERRING ONLY - DENTIST
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility No · Hospice Yes
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223E0200X | Dentist, Endodontics | DN25737 | FL | Yes |
Practice location
3779 Lake Emma RdLake Mary, FL 32746-6156
Phone 407-547-1359
Mailing address
Po Box 190879San Juan, PR 00919-0879
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
Other Endodontics providers in Lake Mary, FL
- Advanced Endodontics Of Lake MaryNPI 1548616113
- Travis Eugene Caissie, D.D.S., M.S.NPI 1265574487
- Shiju CherianNPI 1306164876
- Quyen T. Pham, DMDNPI 1023467925
All 5 Endodontics providers in Lake Mary · All 2,587 providers in Lake Mary
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