Eliz Danielle Santos, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

DDS105134 Issued in CA

Practice address

155 5TH St
San Francisco, CA 94103-2919

Phone

(909) 918-9790

NPI assigned

Sep 12, 2020

Last updated

Sep 12, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Community Medical Wellness Centers USA

  • Federally Qualified Health Center (FQHC)
  • Long Beach, CA
  • NPI 1235500513
  Medicare reassignment NPD
• Community Medical Wellness Centers USA

  • Federally Qualified Health Center (FQHC)
  • Long Beach, CA
  • NPI 1689449571
  NPD

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

{
    "created_epoch": "1599868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599868800000",
    "number": "1326653775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1306 VIA VERDE",
            "city": "SAN DIMAS",
            "state": "CA",
            "postal_code": "917734425",
            "telephone_number": "909-918-9790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 5TH ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941032919",
            "telephone_number": "909-918-9790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTOS",
        "first_name": "ELIZ",
        "middle_name": "DANIELLE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-12",
        "last_updated": "2020-09-12",
        "certification_date": "2020-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "DDS105134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amalen Santos
• Christian Frontera Santos
• Danton Santos
• Deirdre McDermott Santos, FNP
• Edna Talag Santos, D.M.D.
• Evan Forrest Santos
• Gilda Santos
• Julio Santos Jr.
• Kaye Santos
• Liana Rose Santos

• Dentist in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2020; 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.