Individual provider Active NPI

Daniel Niel Dela Cruz, D.M.D., B.S.N.

  • General Practice Dentistry
  • Surprise, AZ
National Provider Identifier
1467981332
Registry record updated Oct 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D009730 Issued in AZ
Practice address
15409 W Greenway Rd Ste 100
Surprise, AZ 85374-4368
Phone
(623) 546-3511
NPI assigned
Jun 5, 2017
Last updated
Oct 2, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 6907 NV
General Practice Dentistry 1223G0001X D08623170 AZ
General Practice Dentistry 1223G0001X D009730 AZ Primary

Addresses

Primary practice location

15409 W Greenway Rd Ste 100
Surprise, AZ 85374-4368

Mailing address

15409 W Greenway Rd Ste 100
Surprise, AZ 85374-4368
Phone (623) 546-3511

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Previously, effective Aug 13, 2024 through Aug 13, 2026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Bachelor on Science - Nursing

State licenses

LicenseStateTypeSpecialty
D009730AZMDGeneral Practice Dentistry
D08623170AZMDGeneral Practice Dentistry
6907NVMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Daniel N Dela Cruz DMD PLLC General Practice CurrentSince Oct 6, 2024 Accepting new patients
Midwestern University PastSince Sep 29, 2024 Accepting new patients
Steele Dental Group PastSince Oct 6, 2024 Accepting new patients

Locations

15409 W Greenway Rd
Ste 100
Surprise, AZ 85374
Phone (623) 546-3511

Interoperability endpoints

  • Direct secure messaging: ddelacruz24960@direct.midwestern.edu

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1496620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727827200000",
    "number": "1467981332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15409 W GREENWAY RD STE 100",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853744368",
            "telephone_number": "623-546-3511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15409 W GREENWAY RD STE 100",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853744368",
            "telephone_number": "623-546-3511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELA CRUZ",
        "first_name": "DANIEL",
        "middle_name": "NIEL",
        "name_prefix": "Dr.",
        "credential": "D.M.D., B.S.N.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-05",
        "last_updated": "2024-10-02",
        "certification_date": "2024-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NV",
            "license": "6907",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D08623170",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D009730",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Surprise, AZ

Sources for this page

Verify at the official NPI Registry.