Active NPI
Elizabeth Cruz-Cruz, EFDA
- Dental Assistant
- Gresham, OR
National Provider Identifier
1770100125
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Assistant
- 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
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 |
|---|---|---|---|---|
| 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
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| 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.