Active NPI
Omar R Cruz, DMD
- Prosthodontics
- Chicago, IL
National Provider Identifier
1659565232
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthodontics
- License
- 019027075
- Practice address
- 1426 W Belmont Ave
Chicago, IL 60657-6898 - Phone
- (773) 528-0068
- Fax
- (773) 528-0088
- NPI assigned
- Aug 28, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prosthodontics | 1223P0700X | 019027075 | IL | Primary |
Addresses
Primary practice location
1426 W Belmont Ave
Chicago, IL 60657-6898
Mailing address
1426 W Belmont Ave
Chicago, IL 60657-6898
Phone (773) 528-0068
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
| License | State | Type | Specialty |
|---|---|---|---|
| 019027075 | IL | MD | Prosthodontist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jose Villa PC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- General Practice Dentistry
- Chicago, IL
- NPI 1437301744
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1188259200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1220572800000",
"number": "1659565232",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1426 W BELMONT AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606576898",
"telephone_number": "773-528-0068",
"fax_number": "773-528-0088"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1426 W BELMONT AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606576898",
"telephone_number": "773-528-0068",
"fax_number": "773-528-0088"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRUZ",
"first_name": "OMAR",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-08-28",
"last_updated": "2008-09-05",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0700X",
"taxonomy_group": "",
"desc": "Dentist, Prosthodontics",
"state": "IL",
"license": "019027075",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.