DR. RUTH WAUQUA BOL DDS
NPI 1124246376
Dentist - Pediatric Dentistry in San Ysidro, CA
About Dr. Ruth Wauqua Bol Dds NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. RUTH WAUQUA BOL DDS (NPI 1124246376) is an individual pediatric dentistry provider in San Ysidro, California, licensed in California (51668) and active in the NPI registry since April 2007. She is enrolled in Medicare PECOS and maintains 2 additional practice locations.
NPPES Registry Identity
Specialties & Licenses 2
Secondary Practice Locations 2
Other Identifiers 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Dr. Ruth Wauqua Bol Dds is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Ruth Bol reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
San Ysidro, CA 92173
- Reassigned Medicare billing, California enrollment
- 577 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 92173 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
SAN YSIDRO, CA 92173
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Ruth Bol's NPI number?
The NPI number for Ruth Bol is 1124246376. It was assigned to this individual provider in the NPPES registry on April 23, 2007.
Where is Ruth Bol located?
Ruth Bol practices at 4004 Beyer Blvd, San Ysidro, CA 92173. The listed phone number is (619) 662-4100.
What is Ruth Bol's specialty?
The primary specialty registered for this NPI is Dentist, specializing in Pediatric Dentistry, with taxonomy code 1223P0221X.
Is Ruth Bol enrolled in Medicare?
Yes. Ruth Bol is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Ruth Bol's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Ruth Bol reassigns Medicare benefits to Centro De Salud De La Comunidad De San Ysidro, Inc. (San Ysidro, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Ruth Bol's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Ruth Bol accept?
Health plans from Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas, Renaissance Dental and TRUASSURE INSURANCE COMPANY list Ruth Bol as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Ruth Bol was last updated on May 24, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Dr. Ruth Wauqua Bol, DDS · NPI 1124246376
Pediatric Dentistry provider in San Ysidro, California. Individual provider, active in the CMS NPPES registry since April 23, 2007.
## Identity
- **NPI:** 1124246376 (Entity type: Individual)
- **Enumerated:** April 23, 2007
- **Primary specialty:** Dentist - Pediatric Dentistry · taxonomy 1223P0221X
- **State license:** 51668 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 4004 BEYER BLVD, San Ysidro, CA 92173-2099
- **Phone:** (619) 662-4100
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health
- **Bills Medicare through:** Centro De Salud De La Comunidad De San Ysidro, Inc. (NPI 1164641965, San Ysidro, CA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** May 24, 2024
- **Other identifiers:** Medicaid Q026775 (TN)
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Source: [NPI Profile](https://npiprofile.com/npi/1124246376) · Data from the CMS NPPES public registry.