Individual provider Active NPI

Evelyn Alexandra Cruz Herbas, DDS

  • General Practice Dentistry
  • Arlington, VA
National Provider Identifier
1174365837
Registry record updated Jun 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
0401418953 Issued in VA
Practice address
3565 Langston Blvd # S3B
Arlington, VA 22207-3756
Phone
(571) 447-5577
NPI assigned
Jun 12, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2024

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 0401418953 VA Primary

Addresses

Primary practice location

3565 Langston Blvd # S3B
Arlington, VA 22207-3756

Mailing address

7223 Adrienne Glen Ave
Springfield, VA 22152-3540

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
0401418953VAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1718150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718150400000",
    "number": "1174365837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7223 ADRIENNE GLEN AVE",
            "city": "SPRINGFIELD",
            "state": "VA",
            "postal_code": "221523540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3565 LANGSTON BLVD # S3B",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222073756",
            "telephone_number": "571-447-5577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUZ HERBAS",
        "first_name": "EVELYN",
        "middle_name": "ALEXANDRA",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-12",
        "last_updated": "2024-06-12",
        "certification_date": "2024-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401418953",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 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.