Individual provider Active NPI

Jazriel Cruz, D.D.S.

  • General Practice Dentistry
  • Ft Lauderdale, FL
National Provider Identifier
1982897609
Registry record updated Sep 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN 18486 Issued in FL
Practice address
2020 E Oakland Park Blvd
Ft Lauderdale, FL 33306-1106
Phone
(954) 566-9812
NPI assigned
Aug 27, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 0401411926 VA
General Practice Dentistry 1223G0001X DN 18486 FL Primary

Addresses

Primary practice location

2020 E Oakland Park Blvd
Ft Lauderdale, FL 33306-1106

Mailing address

2020 E Oakland Park Blvd
Ft Lauderdale, FL 33306-1106
Phone (954) 566-9812

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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

Enrollment IDStateProvider typePAC IDDetails
I20160318001564 VA Order and Referring Only - DentistPractitioner - Dentist 9436456498

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0401411926VAMDDentist
DN 18486FLMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1188172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222128000000",
    "number": "1982897609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 E OAKLAND PARK BLVD",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333061106",
            "telephone_number": "954-566-9812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 E OAKLAND PARK BLVD",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333061106",
            "telephone_number": "954-566-9812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUZ",
        "first_name": "JAZRIEL",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-27",
        "last_updated": "2008-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401411926",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN 18486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ft Lauderdale, FL

Sources for this page

Verify at the official NPI Registry.