Provider Demographics
NPI:1992705891
Name:RUBIN, DAVID M (DDS)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:M
Last Name:RUBIN
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:PO BOX 432
Mailing Address - Street 2:
Mailing Address - City:PIKEVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41502-0432
Mailing Address - Country:US
Mailing Address - Phone:606-218-6409
Mailing Address - Fax:606-218-7509
Practice Address - Street 1:911 BYPASS RD
Practice Address - Street 2:CLINIC 9
Practice Address - City:PIKEVILLE
Practice Address - State:KY
Practice Address - Zip Code:41501-1689
Practice Address - Country:US
Practice Address - Phone:606-218-6409
Practice Address - Fax:606-218-7509
Is Sole Proprietor?:No
Enumeration Date:2005-07-21
Last Update Date:2016-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN14780122300000X
GADN0139081223S0112X
TN9381223S0112X
ND21801223S0112X
KY97111223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA653962447AMedicaid
NDN719016Medicare PIN
FLE1930Medicare PIN
GA653962447AMedicaid
U73543Medicare UPIN