Brenda Mayorga de la Cruz, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

12014411A Issued in IN

Practice address

1002 N Mitthoefer Rd Ste B
Indianapolis, IN 46229-2461

Phone

(317) 898-6666

NPI assigned

Jun 5, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Eastpointe Family Dentistry, LLC

  • General Practice Dentistry
  • Indianapolis, IN
  • NPI 1801649637
  NPD
• Pulos Family Dentistry, LLC

  • General Practice Dentistry
  • Indianapolis, IN
  • NPI 1972016392
  NPD (past)

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

{
    "created_epoch": "1717545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719532800000",
    "number": "1174364822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "426 SPEEDWAY WOODS DR",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462246142",
            "telephone_number": "317-828-2601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1002 N MITTHOEFER RD STE B",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462292461",
            "telephone_number": "317-898-6666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYORGA DE LA CRUZ",
        "first_name": "BRENDA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-05",
        "last_updated": "2024-06-28",
        "certification_date": "2024-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "12014411A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessie Maynard, OT
• Megan Maynard, M.S. CCC-SLP
• Heather Ashton Mayo, MA
• Tamara Mayo
• Domingo Aguas Mayoralgo
• Timothy Mayotte, MD
• Dale R Mayrose, MD
• Mays Medical Academy LLC
• Colleen Mays
• Cynthia J Mays, LMT

• Dentist in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Dentist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2024; 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.