Mary Cruz Aguilar, DENTAL HYGIENIST

Primary specialty

Dental HygienistTaxonomy code 124Q00000X

License

13007812A Issued in IN

Practice address

1901 W Western Ave Ste B
South Bend, IN 46619-3570

Phone

(574) 234-9033

NPI assigned

Aug 31, 2020

Last updated

Aug 31, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1598832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598832000000",
    "number": "1659985497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901B W WESTERN AVE # B",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466193521",
            "telephone_number": "574-234-9033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 W WESTERN AVE STE B",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466193570",
            "telephone_number": "574-234-9033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGUILAR",
        "first_name": "MARY CRUZ",
        "credential": "DENTAL HYGIENIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-31",
        "last_updated": "2020-08-31",
        "certification_date": "2020-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "IN",
            "license": "13007812A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dental Hygienist in South Bend, IN
• Providers in South Bend, IN by specialty
• Dental Hygienist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2020; 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.