NPIMap

Individual provider Active NPI

Enrique Cruz, DDS, MSD

  • Periodontics
  • Austin, TX
National Provider Identifier
1619393469
Registry record updated Mar 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
29766 Issued in TX
Practice address
115 Sandra Muraida Way
Apt 631
Austin, TX 78703-4696
Phone
(317) 362-4592
NPI assigned
Mar 17, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 29766 TX Primary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 29766 TX

Addresses

Primary practice location

115 Sandra Muraida Way
Apt 631
Austin, TX 78703-4696

Mailing address

115 Sandra Muraida Way
Apt 631
Austin, TX 78703-4696
Phone (317) 362-4592

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
29766TXMDClinical Social Worker

Interoperability endpoints

  • Direct secure messaging: ecruz62151@direct.utmsa.com

NPI Registry JSON

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

{
    "created_epoch": "1395014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395014400000",
    "number": "1619393469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 SANDRA MURAIDA WAY",
            "address_2": "APT 631",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787034696",
            "telephone_number": "317-362-4592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 SANDRA MURAIDA WAY",
            "address_2": "APT 631",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787034696",
            "telephone_number": "317-362-4592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUZ",
        "first_name": "ENRIQUE",
        "name_prefix": "Dr.",
        "credential": "DDS, MSD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-03-17",
        "last_updated": "2014-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "TX",
            "license": "29766",
            "primary": true
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "TX",
            "license": "29766",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2014; 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.