Santiago Martin Gardois, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

8442967-9922 Issued in UT

Practice address

3755 W 7800 S
West Jordan, UT 84088-4487

Phone

(801) 781-5820

Fax

(385) 270-8361

NPI assigned

Jul 20, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Cozy Cabin Dental, LLC

  • Dental Clinic/Center
  • West Jordan, UT
  • NPI 1881236701
  NPD

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

{
    "created_epoch": "1342742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583712000000",
    "number": "1336494780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3755 W 7800 S",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840884487",
            "telephone_number": "801-781-5820",
            "fax_number": "385-270-8361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3755 W 7800 S",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840884487",
            "telephone_number": "801-781-5820",
            "fax_number": "385-270-8361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDOIS",
        "first_name": "SANTIAGO",
        "middle_name": "MARTIN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-20",
        "last_updated": "2020-03-09",
        "certification_date": "2020-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "UT",
            "license": "8442967-9922",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "8442967-9922",
            "state": "UT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "care@cozycabindental.com",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "email",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "3755 W 7800 S",
            "city": "West Jordan",
            "state": "UT",
            "country_code": "US",
            "postal_code": "840884487",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Grace Gardner
• Kaden Gardner
• Kristy Gardner
• Megan Gardner
• Whitney Gardner
• Grace Garrett
• William Perry Garso, CMHC
• Grace Gary
• Gaudium Vitae LLC
• Moriah Gayler

• General Practice Dentistry in West Jordan, UT
• Providers in West Jordan, UT by specialty
• General Practice Dentistry in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.