Individual provider Active NPI

Joanna Marie Toledo Santos, DDS

  • General Practice Dentistry
  • Sacramento, CA
National Provider Identifier
1215581640
Registry record updated Jan 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DDS103883 Issued in CA
Practice address
1750 Wright St
Sacramento, CA 95825-4041
Phone
(916) 454-2345
Fax
(916) 457-2667
NPI assigned
Jul 24, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DDS103883 CA Primary

Addresses

Primary practice location

1750 Wright St
Sacramento, CA 95825-4041

Mailing address

5200 Stockton Blvd Ste 110
Sacramento, CA 95820-5492
Phone (916) 455-6600

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20250106003705 CA Order and Referring Only - DentistPractitioner - Dentist 8022546969

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DDS103883CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1563926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736380800000",
    "number": "1215581640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 STOCKTON BLVD STE 110",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958205492",
            "telephone_number": "916-455-6600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1750 WRIGHT ST",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958254041",
            "telephone_number": "916-454-2345",
            "fax_number": "916-457-2667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTOS",
        "first_name": "JOANNA MARIE",
        "middle_name": "TOLEDO",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-24",
        "last_updated": "2025-01-09",
        "certification_date": "2025-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "DDS103883",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.