Individual provider Active NPI

Julio Cruz Ortega, D.D.S.

  • Dentist
  • Montclair, CA
National Provider Identifier
1174816870
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
61485 Issued in CA
Practice address
9509 Central Ave Ste D
Montclair, CA 91763-2400
Phone
(909) 399-3330
Fax
(909) 399-9888
NPI assigned
May 27, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 61485 CA Primary

Addresses

Primary practice location

9509 Central Ave Ste D
Montclair, CA 91763-2400

Mailing address

9509 Central Ave Ste D
Montclair, CA 91763-2400
Phone (909) 399-3330

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
61485CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Julio Ortega DDS Inc CurrentSince Jul 24, 2022 Accepting new patients
Rita Deragobian DDS Inc Dentist PastSince Jul 24, 2022 Accepting new patients

Locations

9509 Central Ave
Ste D
Montclair, CA 91763
Phone (909) 399-3330

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": "1306454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1174816870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9509 CENTRAL AVE STE D",
            "city": "MONTCLAIR",
            "state": "CA",
            "postal_code": "917632400",
            "telephone_number": "909-399-3330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9509 CENTRAL AVE STE D",
            "city": "MONTCLAIR",
            "state": "CA",
            "postal_code": "917632400",
            "telephone_number": "909-399-3330",
            "fax_number": "909-399-9888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORTEGA",
        "first_name": "JULIO",
        "middle_name": "CRUZ",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-05-27",
        "last_updated": "2022-07-21",
        "certification_date": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "61485",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montclair, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.