Individual provider Active NPI

Elizabeth Cruz-Cruz, EFDA

  • Dental Assistant
  • Gresham, OR
National Provider Identifier
1770100125
Registry record updated Jul 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental AssistantTaxonomy code 126800000X
Practice address
600 NE 8TH St Ste 210
Gresham, OR 97030-7341
Phone
(503) 988-4900
NPI assigned
Jul 1, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Assistant 126800000X Primary

Addresses

Primary practice location

600 NE 8TH St Ste 210
Gresham, OR 97030-7341

Mailing address

4850 SW 11TH St Apt 115
Gresham, OR 97080-7312
Phone (503) 957-0562

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Gresham Health Information Exchange (HIE)

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

NPI Registry JSON

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

{
    "created_epoch": "1593561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593561600000",
    "number": "1770100125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4850 SW 11TH ST APT 115",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970807312",
            "telephone_number": "503-957-0562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 NE 8TH ST STE 210",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970307341",
            "telephone_number": "503-988-4900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUZ-CRUZ",
        "first_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "EFDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-01",
        "last_updated": "2020-07-01",
        "certification_date": "2020-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "126800000X",
            "taxonomy_group": "",
            "desc": "Dental Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Gresham",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "N/A",
            "address_1": "4850 SW 11th St Apt 115",
            "city": "Gresham",
            "state": "OR",
            "country_code": "US",
            "postal_code": "970807312",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Gresham, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 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.