A. Rodriguez-Cruz,DDS,Inc.

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

A. RODRIGUEZ-CRUZ,DDS,INC.

Practice address

827 W Valley Blvd
Colton, CA 92324-2001

Phone

(909) 825-2175

Fax

(909) 825-0964

NPI assigned

Oct 24, 2018

Last updated

Oct 24, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mayra A Castellon

Title

Secretary

Phone

(909) 825-2175

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1540339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540339200000",
    "number": "1255808648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 E ARROW HWY # 724",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917405607",
            "telephone_number": "909-825-2175",
            "fax_number": "909-825-0964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "827 W VALLEY BLVD",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923242001",
            "telephone_number": "909-825-2175",
            "fax_number": "909-825-0964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A. RODRIGUEZ-CRUZ,DDS,INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-24",
        "last_updated": "2018-10-24",
        "status": "A",
        "authorized_official_last_name": "CASTELLON",
        "authorized_official_first_name": "MAYRA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "909-825-2175"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1992837652",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2018; 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.