Active NPI
Ethel S Cruz, D.M.D.
- General Practice Dentistry
- Corona, CA
National Provider Identifier
1316110711
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 51913
- Practice address
- 1760 W 6TH St Ste 100a
Corona, CA 92882-2790 - Phone
- (951) 735-7300
- NPI assigned
- Apr 7, 2008
- Last updated
- Jun 13, 2020
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 51913 | CA | Primary |
Addresses
Primary practice location
1760 W 6TH St Ste 100a
Corona, CA 92882-2790
Mailing address
1760 W 6TH St Ste 100a
Corona, CA 92882-2790
Phone (951) 735-3000
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1207526400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1592006400000",
"number": "1316110711",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1760 W 6TH ST STE 100A",
"city": "CORONA",
"state": "CA",
"postal_code": "928822790",
"telephone_number": "951-735-3000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1760 W 6TH ST STE 100A",
"city": "CORONA",
"state": "CA",
"postal_code": "928822790",
"telephone_number": "951-735-7300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRUZ",
"first_name": "ETHEL",
"middle_name": "S",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-04-07",
"last_updated": "2020-06-13",
"certification_date": "2020-06-13",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "51913",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Corona, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.