Maria a. Cruz-Agustin D.D.S Inc

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

BL00065456 Issued in CA

Legal business name

MARIA A. CRUZ-AGUSTIN D.D.S INC

Practice address

1950 S Grove Ave Ste 106a
Ontario, CA 91761-5693

Phone

(909) 930-1197

Fax

(909) 930-1233

NPI assigned

Apr 19, 2007

Organization subpart

No

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

Authorized official

Name

Sam Agustin

Title

Ceo

Phone

(909) 930-1197

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1248307200000",
    "number": "1205053220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 S GROVE AVE STE 106A",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917615693",
            "telephone_number": "909-930-1197",
            "fax_number": "909-930-1233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1950 S GROVE AVE STE 106A",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917615693",
            "telephone_number": "909-930-1197",
            "fax_number": "909-930-1233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARIA A. CRUZ-AGUSTIN D.D.S INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-19",
        "last_updated": "2009-07-23",
        "status": "A",
        "authorized_official_last_name": "AGUSTIN",
        "authorized_official_first_name": "SAM",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "909-930-1197"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "BL00065456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carolina Maravilla
• Colleen Elizabeth Maravilla, RPT
• Samantha Maravillo
• Jacob Calvin Marcelo
• Imelda Mares, MASTERS IN SCIENCE
• Maria Vargas Licensed Clinical Social Worker (MV Therapy)
• Maria Z. Carbajal, DDS, Inc
• Alejandro Marin
• Alicia Socorro Marin, D.C.
• Rosa Itzel Marin

• General Practice Dentistry in Ontario, CA
• Providers in Ontario, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2009; 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.