Active NPI
Ninoshka M Cruz-Correa
- Dentist
- San Juan, PR
National Provider Identifier
1578290490
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 3464
- Practice address
- 1210 Calle Cadiz
San Juan, PR 00920-3841 - Phone
- (787) 781-3187
- NPI assigned
- Aug 2, 2022
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Dentist | 122300000X | 3464 | PR | Primary |
Addresses
Primary practice location
1210 Calle Cadiz
San Juan, PR 00920-3841
Mailing address
Urb Loiza Valley Calle Crisantemo J333
Canovanas, PR 00729
Phone (787) 518-9540
Other practice location 1
874 Willoughby Ave # 708
Brooklyn, NY 11221-2410
Phone (787) 518-9540
Other practice location 2
urb Loiza Valley calle crisantemo J333
Canovanas, PR 00729
Phone (787) 518-9540
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20231129003741 | PR | Order and Referring Only - Dentist | 3375991441 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3464 | PR | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1659398400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701907200000",
"number": "1578290490",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "URB LOIZA VALLEY CALLE CRISANTEMO J333",
"city": "CANOVANAS",
"state": "PR",
"postal_code": "00729",
"telephone_number": "787-518-9540"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1210 CALLE CADIZ",
"city": "SAN JUAN",
"state": "PR",
"postal_code": "009203841",
"telephone_number": "787-781-3187"
}
],
"practiceLocations": [
{
"address_1": "874 Willoughby Ave # 708",
"address_purpose": "LOCATION",
"city": "Brooklyn",
"state": "NY",
"postal_code": "112212410",
"country_code": "US",
"telephone_number": "787-518-9540",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "urb Loiza Valley calle crisantemo J333",
"address_purpose": "LOCATION",
"city": "Canovanas",
"state": "PR",
"postal_code": "00729",
"country_code": "US",
"telephone_number": "787-518-9540",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CRUZ-CORREA",
"first_name": "NINOSHKA",
"middle_name": "M",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-08-02",
"last_updated": "2023-12-07",
"certification_date": "2023-12-07",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "PR",
"license": "3464",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Juan, PR
- Kianie Marie Cruz Rosado
- Ricardo Manuel Cruz Sanchez
- Roberto Cruz-Barreto, M.D.
- Alexis Manuel Cruz-Chacon, MD
- Irma Fernanda Cruz-Class, SLP
- Jorge Javier Cruz-Cruz, MD
- Elsie Ivette Cruz-Cuevas, MD
- Angel Damian Cruz-de la Cruz, DMD
- Cristina Michelle Cruz-Esteves, PHD
- Iadelisse Cruz-Gonzalez, PHARMD, BCGP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2023; 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.