Individual provider Active NPI

Christian Santana, DDS

  • General Practice Dentistry
  • Phila, PA
National Provider Identifier
1104037613
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
046021 Issued in NY
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.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, PA2 enrollments
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.

Medicare enrollment records 2

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
I20220804003120 NY Practitioner - Dentist 7416339635 Reassigns benefits to 4 organizations
I20231208002165 PA Practitioner - Oral SurgeryPractitioner - Dentist 7416339635

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046021NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Bonita Sonrisa Dental Mso CurrentSince Aug 13, 2022 Accepting new patients
Alejandro Williams Dental Office PC CurrentSince Apr 21, 2022 Accepting new patients
3545 Johnson Blvd Dental PC CurrentSince Jul 26, 2022 Accepting new patients
Bonita Sonrisa Dental Ipa CurrentSince Jun 8, 2022 Accepting new patients
43 Chruch Street Dental PC CurrentSince Jun 18, 2022 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)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 046021 NY Primary

Addresses

NPPES NPI Registry

Primary 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
IdentifierTypeStateIssuer
01568818MedicaidNY

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

Verify at the official NPI Registry.