Individual provider Active NPI

Alice Abrera Bruce, DDS

  • Dentist
  • Santa Clara, CA
National Provider Identifier
1639247851
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
40543 Issued in CA
Practice address
1500 Los Padres Blvd
Suite 101
Santa Clara, CA 95050-4462
Phone
(408) 244-3867
Fax
(408) 244-4049
NPI assigned
Dec 4, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 40543 CA Primary

Addresses

Primary practice location

1500 Los Padres Blvd
Suite 101
Santa Clara, CA 95050-4462

Mailing address

1500 Los Padres Blvd
Suite 101
Santa Clara, CA 95050-4462
Phone (408) 244-3867

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
40543CAMDPediatric Physical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1639247851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 LOS PADRES BLVD",
            "address_2": "SUITE 101",
            "city": "SANTA CLARA",
            "state": "CA",
            "postal_code": "950504462",
            "telephone_number": "408-244-3867",
            "fax_number": "408-244-4049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 LOS PADRES BLVD",
            "address_2": "SUITE 101",
            "city": "SANTA CLARA",
            "state": "CA",
            "postal_code": "950504462",
            "telephone_number": "408-244-3867",
            "fax_number": "408-244-4049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUCE",
        "first_name": "ALICE",
        "middle_name": "ABRERA",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "40543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Clara, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.