Individual provider Active NPI

Moraima A De la Cruz, D.D.S.

  • General Practice Dentistry
  • Jackson Heights, NY
National Provider Identifier
1023007473
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
045647-1 Issued in NY
Practice address
8910 35TH Ave
Jackson Heights, NY 11372-5758
Phone
(718) 426-3705
Fax
(718) 426-3836
NPI assigned
Oct 18, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 045647-1 NY Primary

Addresses

Primary practice location

8910 35TH Ave
Jackson Heights, NY 11372-5758

Mailing address

3 Sparrow Ave
Chestnut Ridge, NY 10977-6313
Phone (845) 573-9023

Other identifiers 1

IdentifierTypeStateIssuer
01538898MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
045647-1NYMDGeneral Practice Dentistry

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1129593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1023007473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 SPARROW AVE",
            "city": "CHESTNUT RIDGE",
            "state": "NY",
            "postal_code": "109776313",
            "telephone_number": "845-573-9023",
            "fax_number": "845-573-9022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8910 35TH AVE",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "113725758",
            "telephone_number": "718-426-3705",
            "fax_number": "718-426-3836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE LA CRUZ",
        "first_name": "MORAIMA",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-18",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "045647-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01538898",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson Heights, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.