Active NPI
Johanna De la Cruz
- Dental Assistant
- San Juan, PR
National Provider Identifier
1275888133
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Assistant
- License
- 5257
- Practice address
- 130 Ave Arterial Hostos
Cond Hato Rey Centro Edf O Apt 301
San Juan, PR 00918-5200 - Phone
- (787) 342-9334
- NPI assigned
- Jul 17, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Assistant | 126800000X | 5257 | PR | Primary |
Addresses
Primary practice location
130 Ave Arterial Hostos
Cond Hato Rey Centro Edf O Apt 301
San Juan, PR 00918-5200
Mailing address
130 Arterial Hostos
Cond Hato Rey Centro Edf O Apt 301
San Juan, PR 00918
Phone (787) 342-9334
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
| License | State | Type | Specialty |
|---|---|---|---|
| 5257 | PR | MD | Dental Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1342483200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1342483200000",
"number": "1275888133",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "130 ARTERIAL HOSTOS",
"address_2": "COND HATO REY CENTRO EDF O APT 301",
"city": "SAN JUAN",
"state": "PR",
"postal_code": "00918",
"telephone_number": "787-342-9334"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "130 AVE ARTERIAL HOSTOS",
"address_2": "COND HATO REY CENTRO EDF O APT 301",
"city": "SAN JUAN",
"state": "PR",
"postal_code": "009185200",
"telephone_number": "787-342-9334"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DE LA CRUZ",
"first_name": "JOHANNA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-07-17",
"last_updated": "2012-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "126800000X",
"taxonomy_group": "",
"desc": "Dental Assistant",
"state": "PR",
"license": "5257",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Juan, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.