Roberto Santiago

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN13652 Issued in FL

Practice address

5 Arredondo Ave
Suite a
St Augustine, FL 32080-4573

Phone

(904) 824-0990

Fax

(904) 824-5898

NPI assigned

Jun 7, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

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

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188432000000",
    "number": "1225078207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 ARREDONDO AVE",
            "address_2": "SUITE A",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320804573",
            "telephone_number": "904-824-0990",
            "fax_number": "904-824-5898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 ARREDONDO AVE",
            "address_2": "SUITE A",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320804573",
            "telephone_number": "904-824-0990",
            "fax_number": "904-824-5898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTIAGO",
        "first_name": "ROBERTO",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2007-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN13652",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "59-3725848",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erica Sanes, A.P.
• Sanford Clinic North
• Jana Sanford-Heller
• Cheryl Santana
• Julianna Santiago
• Charlyn Santonil, ARNP
• Diane Santopadre, ARNP
• Andrew Arnold Sappington III, PSYCHOLOGIST
• Larry Charles Sargent, MA
• Aurealyn Frendol Sarker, NP

• General Practice Dentistry in St Augustine, FL
• Providers in St Augustine, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 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.

Verify at the official NPI Registry.