Individual provider Active NPI

Darcy Catherine Cruikshank, DMD MSD

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Forest Grove, OR
National Provider Identifier
1285717579
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
D8508 Issued in OR
Practice address
1911 Mountain View Lane
#100
Forest Grove, OR 97116-2382
Phone
(503) 359-5408
Fax
(503) 359-0584
NPI assigned
Oct 23, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X D8508 OR Primary

Addresses

Primary practice location

1911 Mountain View Lane
#100
Forest Grove, OR 97116-2382

Mailing address

4475 NW Neskowin Ave
Portland, OR 97229-2803
Phone (503) 705-7161

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
D8508ORMDOrthodontics and Dentofacial Orthopedic Dentist

NPI Registry JSON

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1285717579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4475 NW NESKOWIN AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972292803",
            "telephone_number": "503-705-7161",
            "fax_number": "503-359-0584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1911 MOUNTAIN VIEW LANE",
            "address_2": "#100",
            "city": "FOREST GROVE",
            "state": "OR",
            "postal_code": "971162382",
            "telephone_number": "503-359-5408",
            "fax_number": "503-359-0584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUIKSHANK",
        "first_name": "DARCY",
        "middle_name": "CATHERINE",
        "name_prefix": "Mrs.",
        "credential": "DMD MSD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "OR",
            "license": "D8508",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Grove, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.