Individual provider Active NPI

Felix Omar Santiago

  • General Practice Dentistry
  • San Juan, PR
National Provider Identifier
1336593474
Registry record updated Oct 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
3274 Issued in PR
Practice address
430 Ave. San Claudio Urb. Sagrado Corazon
San Juan, PR 00926
Phone
(787) 761-0888
NPI assigned
Apr 14, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 12, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 3274 PR Primary

Addresses

Primary practice location

430 Ave. San Claudio Urb. Sagrado Corazon
San Juan, PR 00926

Mailing address

HC 1 Box 5271
Ciales, PR 00638

Other practice location 1

Carr 5 Avenida Central Juanita Final
Bayamon, PR 00960
Phone (787) 774-3344 ext. 6320

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
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
I20181127002097 PR Order and Referring Only - DentistPractitioner - Dentist 0446594758

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3274PRMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Clinica Dental Torres Fernandez LLC General Practice PastSince May 24, 2020 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": "1460592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539302400000",
    "number": "1336593474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HC 1 BOX 5271",
            "city": "CIALES",
            "state": "PR",
            "postal_code": "00638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 AVE. SAN CLAUDIO URB. SAGRADO CORAZON",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00926",
            "telephone_number": "787-761-0888"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Carr 5 Avenida Central Juanita Final",
            "address_purpose": "LOCATION",
            "city": "Bayamon",
            "state": "PR",
            "postal_code": "00960",
            "country_code": "US",
            "telephone_number": "787-774-3344 x6320",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANTIAGO",
        "first_name": "FELIX",
        "middle_name": "OMAR",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-04-14",
        "last_updated": "2018-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "PR",
            "license": "3274",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.