Active NPI
Christian Santana, DDS
- General Practice Dentistry
- Phila, PA
National Provider Identifier
1104037613
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 046021
- Practice address
- 29 10 North 5TH Street
Phila, PA 19133 - Phone
- (215) 225-2392
- NPI assigned
- May 25, 2007
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 5
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Public Health Dentistry
- Bronx, NY
- NPI 1700343233
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY, PA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Medicare enrollment records 2
Medicare enrollment files| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220804003120 | NY | Practitioner - Dentist | 7416339635 | Reassigns benefits to 4 organizations |
| I20231208002165 | PA | Practitioner - Oral Surgery | 7416339635 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 046021 | NY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bonita Sonrisa Dental Mso | Current | Accepting new patients | |
| Alejandro Williams Dental Office PC | Current | Accepting new patients | |
| 3545 Johnson Blvd Dental PC | Current | Accepting new patients | |
| Bonita Sonrisa Dental Ipa | Current | Accepting new patients | |
| 43 Chruch Street Dental PC | Current | Accepting new patients |
Locations
759 4th Ave
Brooklyn, NY 11232
Phone (718) 832-1194
134 North Ave
Ste 206
New Rochelle, NY 10801
Phone (914) 740-4944
Specialties & licenses 1
NPPES NPI Registry| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 046021 | NY | Primary |
Addresses
NPPES NPI RegistryPrimary practice location
29 10 North 5TH Street
Phila, PA 19133
Mailing address
29 10 North 5TH Street
Phila, PA 19133
Other identifiers 1
NPPES NPI Registry| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01568818 | Medicaid | NY |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 9, 2007.
{
"created_epoch": "1180051200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1104037613",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "29 10 NORTH 5TH STREET",
"city": "PHILA",
"state": "PA",
"postal_code": "19133"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "29 10 NORTH 5TH STREET",
"city": "PHILA",
"state": "PA",
"postal_code": "19133",
"telephone_number": "215-225-2392"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANTANA",
"first_name": "CHRISTIAN",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-25",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NY",
"license": "046021",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01568818",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Phila, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.