Active NPI
Victoria Santibanez, DDS
- Dentist
- Katy, TX
National Provider Identifier
1316328453
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 31000
- Practice address
- 5102 FM 1463 Rd Ste 100
Katy, TX 77494-7871 - Phone
- (281) 204-2156
- Fax
- (281) 547-7340
- NPI assigned
- Jun 15, 2015
- Last updated
- Jan 8, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 31000 | TX | Primary |
Addresses
Primary practice location
5102 FM 1463 Rd Ste 100
Katy, TX 77494-7871
Mailing address
22207 Merrymount Dr
Katy, TX 77450-2419
Phone (214) 808-4726
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20161024001985 | TX | Order and Referring Only - Dentist | 9436437506 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 31000 | TX | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fulshear Modern Dentistry,PC | Dentist | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1434326400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1610064000000",
"number": "1316328453",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22207 MERRYMOUNT DR",
"city": "KATY",
"state": "TX",
"postal_code": "774502419",
"telephone_number": "214-808-4726"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5102 FM 1463 RD STE 100",
"city": "KATY",
"state": "TX",
"postal_code": "774947871",
"telephone_number": "281-204-2156",
"fax_number": "281-547-7340"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANTIBANEZ",
"first_name": "VICTORIA",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-06-15",
"last_updated": "2021-01-08",
"certification_date": "2021-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "31000",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Katy, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2021; 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.