Active NPI
Carola De la Cruz, DDS
- Pediatric Dentistry
- Leesburg, VA
National Provider Identifier
1902057979
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 0401412920
- Practice address
- 1509 Dodona Ter
Suite 105a
Leesburg, VA 20175-4709 - Phone
- (571) 293-0244
- NPI assigned
- Oct 8, 2008
- 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 |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 0401412920 | VA | Primary |
Addresses
Primary practice location
1509 Dodona Ter
Suite 105a
Leesburg, VA 20175-4709
Mailing address
1509 Dodona Ter Ste 105a
Leesburg, VA 20175-4709
Phone (571) 293-0244
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 |
|---|---|---|---|
| 0401412920 | VA | MD | Pediatric Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Treasured Smiles Pediatric Dentistry | Pediatric Dentistry | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Pediatric Dentistry
- Leesburg, VA
- NPI 1225465131
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1223424000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1549843200000",
"number": "1902057979",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1509 DODONA TER STE 105A",
"city": "LEESBURG",
"state": "VA",
"postal_code": "201754709",
"telephone_number": "571-293-0244"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1509 DODONA TER",
"address_2": "SUITE 105A",
"city": "LEESBURG",
"state": "VA",
"postal_code": "201754709",
"telephone_number": "571-293-0244"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DE LA CRUZ",
"first_name": "CAROLA",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-10-08",
"last_updated": "2019-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "VA",
"license": "0401412920",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Leesburg, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.