Individual provider Active NPI

Steven J Santucci, D.D.S.

  • General Practice Dentistry
  • Trenton, NJ
National Provider Identifier
1235212176
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
22DI01310100 Issued in NJ
Practice address
1100 S Broad St
Trenton, NJ 08611-1410
Phone
(609) 393-6404
Fax
(609) 393-6424
NPI assigned
Oct 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 22DI01310100 NJ Primary

Addresses

Primary practice location

1100 S Broad St
Trenton, NJ 08611-1410

Mailing address

1100 S Broad St
Trenton, NJ 08611-1410
Phone (609) 393-6404

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20180103001115 PA Order and Referring Only - DentistPractitioner - Dentist 4688932221

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22DI01310100NJMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Santucci and Weiss, PA General Practice Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1235212176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 S BROAD ST",
            "city": "TRENTON",
            "state": "NJ",
            "postal_code": "086111410",
            "telephone_number": "609-393-6404",
            "fax_number": "609-393-6424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 S BROAD ST",
            "city": "TRENTON",
            "state": "NJ",
            "postal_code": "086111410",
            "telephone_number": "609-393-6404",
            "fax_number": "609-393-6424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTUCCI",
        "first_name": "STEVEN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "22DI01310100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Trenton, NJ

Sources for this page

Verify at the official NPI Registry.