Dr. Lynne A Baldassari-Cruz, D.D.S.
Dentist, Endodontics in San Carlos, CA. Individual provider (NPI-1).
NPI number1629136015
StatusActive
Last updated in NPPESSep 3, 2013
Details
- NPI
- 1629136015
- Entity type
- Individual (NPI-1)
- Name
- Dr. Lynne A Baldassari-Cruz
- Credential
- D.D.S.
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Dec 5, 2006
- Last updated
- Sep 3, 2013
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility No · Hospice Yes
- Medicare opt-out
- Sep 14, 2015 to Sep 14, 2027
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223E0200X | Dentist, Endodontics | 38395 | CA | Yes |
Practice location
1028 Laurel StSan Carlos, CA 94070-3919
Phone 650-595-3722 · Fax 650-595-3636
Mailing address
405 El Camino Real#622
Menlo Park, CA 94025-5240
Phone 650-380-1337 · Fax 650-376-3326
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