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DR. DONALD KIPP RUDDELL DDS
NPI 1417986415
Dentist in Oakland, CA

Active since July 02, 2006Opted out of Medicare · through Sep 14, 2027
298 GRAND AVE, SUITE 200, OAKLAND, CA 94610(510) 452-1068(510) 452-3120 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. Donald Kipp Ruddell Dds NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. DONALD KIPP RUDDELL DDS (NPI 1417986415) is an individual dentist in Oakland, California, licensed in California (32392) and active in the NPI registry since July 2006. He has opted out of Medicare through September 14, 2027 and remains eligible to order and refer.

NPPES Registry Identity

NPI1417986415
Entity TypeIndividualMale
Primary Taxonomy122300000X
Provider Legal NameDR. DONALD KIPP RUDDELLCredential: DDS
Location Address298 GRAND AVE, SUITE 200Oakland, CA 94610
Mailing Address298 Grand Ave, Suite 200Oakland, CA 94610 · (510) 452-1068 · Fax (510) 452-3120
Phone(510) 452-1068
Fax(510) 452-3120
Sole ProprietorNo
Enumeration DateJuly 2, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1417986415 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
License✔ Licensed in CA · 32392
Definition
A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.
298 GRAND AVE, Oakland, CA 94610
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Donald Kipp Ruddell Dds has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from September 14, 2015 through September 14, 2027.

Opt-Out Effective DateSeptember 14, 2015
Opt-Out In Effect ThroughSeptember 14, 2027Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 94610 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$104.51 typical visit price
range $69.00 – $202.35
Typical copayment $26.12 (range $17.25 – $50.58)
Most-billed visit code 99203
Established Patient
$84.91 typical visit price
range $23.44 – $166.46
Typical copayment $21.22 (range $5.86 – $41.61)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. STEPHEN HAYNES CARLSON PSYD
Psychologist (Clinical)
298 GRAND AVE, #100
OAKLAND, CA 94610
Alameda County (510) 566-1076
THOMAS MATTHEW KAISER DDS
Dentist (General Practice)
298 GRAND AVE, SUITE 200
OAKLAND, CA 94610
Alameda County (804) 675-5251
FERIEL EL GHAOUI DDS
Dentist (General Practice)
298 GRAND AVE
OAKLAND, CA 94610
Alameda County (510) 834-7734

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 Donald Ruddell's NPI number?

The NPI number for Donald Ruddell is 1417986415. It was assigned to this individual provider in the NPPES registry on July 2, 2006.

Where is Donald Ruddell located?

Donald Ruddell practices at 298 Grand Ave Suite 200, Oakland, CA 94610. The listed phone number is (510) 452-1068.

What is Donald Ruddell's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Is Donald Ruddell enrolled in Medicare?

No. Donald Ruddell has opted out of Medicare through September 14, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Donald Ruddell was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.