Lynne A Baldassari-Cruz, D.D.S.

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

38395 Issued in CA

Practice address

1028 Laurel St
San Carlos, CA 94070-3919

Phone

(650) 595-3722

Fax

(650) 595-3636

NPI assigned

Dec 5, 2006

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

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

Yes, effective Sep 14, 2015 through Sep 14, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• San Carlos Endodontics

  • Dental Clinic/Center
  • San Carlos, CA
  • NPI 1063846533
  NPD (past) Authorized official
• Polly Chan DDS Inc

  • Dentist
  • Foster City, CA
  • NPI 1508931247
  NPD (past)

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378166400000",
    "number": "1629136015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 EL CAMINO REAL",
            "address_2": "#622",
            "city": "MENLO PARK",
            "state": "CA",
            "postal_code": "940255240",
            "telephone_number": "650-380-1337",
            "fax_number": "650-376-3326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1028 LAUREL ST",
            "city": "SAN CARLOS",
            "state": "CA",
            "postal_code": "940703919",
            "telephone_number": "650-595-3722",
            "fax_number": "650-595-3636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALDASSARI-CRUZ",
        "first_name": "LYNNE",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-05",
        "last_updated": "2013-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "CA",
            "license": "38395",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy Kate Bainton, AMFT
• Bruce Steven Baker, M.D.
• Catherine Baker, M.D.
• Jean E Baker, L.C.S.W.
• Jeffrey Baker, MPT
• Angela Susan Ballard, LMFT 120205, PCCI
• Hannah Rose Banks
• Norman Leroy Banks, MD
• Ritu Bansal
• Ivana T Barrios

• Endodontics in San Carlos, CA
• Providers in San Carlos, CA by specialty
• Endodontics in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.