Active NPI
Stephanie Cruz, DMD
- Dentist
- Elizabeth, NJ
National Provider Identifier
1679982227
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 22D102579000
- Practice address
- 105 Elmora Ave
Elizabeth, NJ 07202-1614 - Phone
- (908) 354-1490
- NPI assigned
- Aug 7, 2014
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 22D102579000 | NJ | Primary |
Addresses
Primary practice location
105 Elmora Ave
Elizabeth, NJ 07202-1614
Mailing address
105 Elmora Ave
Elizabeth, NJ 07202-1614
Phone (908) 354-1490
Medicare participation
Medicare enrollment files- 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
- Opted out of Medicare
- Yes, effective Jan 27, 2016 through Jan 27, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22D102579000 | NJ | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1407369600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1407369600000",
"number": "1679982227",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "105 ELMORA AVE",
"city": "ELIZABETH",
"state": "NJ",
"postal_code": "072021614",
"telephone_number": "908-354-1490"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "105 ELMORA AVE",
"city": "ELIZABETH",
"state": "NJ",
"postal_code": "072021614",
"telephone_number": "908-354-1490"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRUZ",
"first_name": "STEPHANIE",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-08-07",
"last_updated": "2014-08-07",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NJ",
"license": "22D102579000",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Elizabeth, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2014; 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.