Individual provider Active NPI

Nicole Marie Colon Cruz, DMD

  • General Practice Dentistry
  • Boston, MA
National Provider Identifier
1083319602
Registry record updated Aug 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN10000791 Issued in MA
Practice address
36 Chauncy St
Boston, MA 02111-2209
Phone
(617) 338-5000
NPI assigned
Apr 3, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2025

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 DN10000791 MA Primary

Addresses

Primary practice location

36 Chauncy St
Boston, MA 02111-2209

Mailing address

35 Lomasney Way Apt 1712
Boston, MA 02114-1506
Phone (787) 547-2897

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
DN10000791MAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Boston Dental General Practice PastSince Aug 3, 2025 Accepting new patients
Boston Dental, PC PastSince Aug 3, 2025 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1680480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754092800000",
    "number": "1083319602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 LOMASNEY WAY APT 1712",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021141506",
            "telephone_number": "787-547-2897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 CHAUNCY ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021112209",
            "telephone_number": "617-338-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLON CRUZ",
        "first_name": "NICOLE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-03",
        "last_updated": "2025-08-02",
        "certification_date": "2025-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "DN10000791",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2025; 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.