Individual provider Active NPI

Manuel Diaz-Santiago, DMD

  • General Practice Dentistry
  • Juncos, PR
National Provider Identifier
1215908587
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
818 Issued in PR
Practice address
32 Calle Martinez
Juncos, PR 00777-3548
Phone
(787) 734-7336
Fax
(787) 734-3036
NPI assigned
Jan 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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 818 PR Primary

Addresses

Primary practice location

32 Calle Martinez
Juncos, PR 00777-3548

Mailing address

32 Calle Martinez
PO Box 1722
Juncos, PR 00777-3548
Phone (787) 734-7336

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
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
I20160502001339 PR Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 7416256102

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
818PRMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1138320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1215908587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32 CALLE MARTINEZ",
            "address_2": "PO BOX 1722",
            "city": "JUNCOS",
            "state": "PR",
            "postal_code": "007773548",
            "telephone_number": "787-734-7336",
            "fax_number": "787-734-3036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32 CALLE MARTINEZ",
            "city": "JUNCOS",
            "state": "PR",
            "postal_code": "007773548",
            "telephone_number": "787-734-7336",
            "fax_number": "787-734-3036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAZ-SANTIAGO",
        "first_name": "MANUEL",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-27",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PR",
            "license": "818",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Juncos, PR

Sources for this page

Verify at the official NPI Registry.