Provider Demographics
NPI:1851985808
Name:RUTH, CALEB MITCHELL (DDS)
Entity type:Individual
Prefix:
First Name:CALEB
Middle Name:MITCHELL
Last Name:RUTH
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2531 CHERRY ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64108-2746
Mailing Address - Country:US
Mailing Address - Phone:573-645-7715
Mailing Address - Fax:
Practice Address - Street 1:UK COLLEGE OF DENTISTRY DENTAL SCIENCE BLDG 800 ROSE
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536-0001
Practice Address - Country:US
Practice Address - Phone:336-885-9323
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-21
Last Update Date:2022-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYD10640122300000X
KY10640122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist