Active NPI
Jennifer Vale Cruz, D.M.D
- Dentist
- Camp Pendleton, CA
National Provider Identifier
1720234974
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 57367
- Practice address
- 1St Den BN/NDC
13 Ambc
Camp Pendleton, CA 92055-5221 - Phone
- (760) 725-5578
- NPI assigned
- Aug 7, 2008
- Sex
- Female
- Sole proprietor
- Yes
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 | 57367 | CA | Primary |
Addresses
Primary practice location
1St Den BN/NDC
13 Ambc
Camp Pendleton, CA 92055-5221
Mailing address
PO Box 555221
Camp Pendleton, CA 92055-5221
Phone (760) 725-5578
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 |
|---|---|---|---|
| 57367 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1218067200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1269302400000",
"number": "1720234974",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 555221",
"city": "CAMP PENDLETON",
"state": "CA",
"postal_code": "920555221",
"telephone_number": "760-725-5578"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1ST DEN BN/NDC",
"address_2": "13 AMBC",
"city": "CAMP PENDLETON",
"state": "CA",
"postal_code": "920555221",
"telephone_number": "760-725-5578"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VALE CRUZ",
"first_name": "JENNIFER",
"credential": "D.M.D",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-08-07",
"last_updated": "2010-03-23",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "57367",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Camp Pendleton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.