Ingrid Regina Thuyha Mack Cruz

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

53243 Issued in CA

Practice address

2598 S Archibald Ave Ste C
Ontario, CA 91761-6500

Phone

(909) 947-0670

NPI assigned

May 9, 2008

Last updated

Oct 18, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Ingrid Mack Cruz DDS a Professional Dental Corporation

  • General Practice Dentistry
  • Ontario, CA
  • NPI 1114206828
  NPD (past)

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

{
    "created_epoch": "1210291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666051200000",
    "number": "1922275916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2598 S ARCHIBALD AVE STE C",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917616500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2598 S ARCHIBALD AVE STE C",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917616500",
            "telephone_number": "909-947-0670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACK CRUZ",
        "first_name": "INGRID REGINA",
        "middle_name": "THUYHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-09",
        "last_updated": "2022-10-18",
        "certification_date": "2022-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "53243",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Isabel Juliette Macias
• Jacqueline Macias
• Josette M Macias
• Kirsten Macias
• Marlene Macias
• Ashley Madden
• Tianca Madden
• Xavier Madere
• Norma P Madrid, MSW
• Vivian Madrid

• General Practice Dentistry in Ontario, CA
• Providers in Ontario, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.