Jezelle Edith Cruz

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2857 Issued in PR

Practice address

13 Ave Los Veteranos
Guayama, PR 00784-5972

Phone

(787) 686-6199

Fax

(787) 686-6199

NPI assigned

Sep 14, 2010

Last updated

Mar 21, 2013By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1284422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363824000000",
    "number": "1356659270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "418 CALLE SUIZA APT 404",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009173621",
            "telephone_number": "787-686-6199",
            "fax_number": "787-686-6199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13 AVE LOS VETERANOS",
            "city": "GUAYAMA",
            "state": "PR",
            "postal_code": "007845972",
            "telephone_number": "787-686-6199",
            "fax_number": "787-686-6199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUZ",
        "first_name": "JEZELLE",
        "middle_name": "EDITH",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-09-14",
        "last_updated": "2013-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PR",
            "license": "2857",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ericberto Cotto, O.D.
• Gabriel Omar Covas, MD
• Cristal Ambulance System
• Lorenna Grisell Cruz Rivera, M.D.
• Victor Cruz-Collazo
• Juan Antonio Davila-Lopes, MD
• Reynaldo Jose De Jesus Carrasquillo, PHARMD
• Eddie Joel De Jesus de Armas, PHARMD
• Amarelis De Jesus Rosario, MD
• Juan Andres De Jesus Soto, MD

• General Practice Dentistry in Guayama, PR
• Providers in Guayama, PR by specialty
• General Practice Dentistry in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.