Individual provider Active NPI

Eduardo Julian Santos

  • Dentist
  • Mount Orab, OH
National Provider Identifier
1366135618
Registry record updated Nov 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
30.027231 Issued in OH
Practice address
150 Health Partners Cir
Mount Orab, OH 45154-8610
Phone
(937) 444-2514
Fax
(937) 444-8012
NPI assigned
Jun 1, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 30.027231 OH Primary

Addresses

Primary practice location

150 Health Partners Cir
Mount Orab, OH 45154-8610

Mailing address

424 Wards Corner Rd Ste 200
Loveland, OH 45140-6966
Phone (513) 707-4041

Other identifiers 1

IdentifierTypeStateIssuer
0079795MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20241210003598 OH Practitioner - Dentist 9436685732 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30.027231OHMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Healthsource of Ohio, Inc. Current Accepting new patients
Healthsource of Ohio Inc Current Accepting new patients
Healthsource of Ohio, Inc. Current Accepting new patients
Healthsource of Ohio, Inc. Current Accepting new patients
Healthsource of Ohio, Inc. Current Accepting new patients
Healthsource of Ohio, Inc. Current Accepting new patients
Healthsource of Ohio, Inc. Current Accepting new patients
Healthsource of Ohio, Inc. CurrentSince Nov 25, 2024 Accepting new patients
Healthsource of Ohio, Inc. Current Accepting new patients
Healthsource of Ohio, Inc. CurrentSince Nov 25, 2024 Accepting new patients
Healthsource of Ohio, Inc. Current Accepting new patients
Healthsource of Ohio Inc Current Accepting new patients
Healthsource of Ohio, Inc. Current Accepting new patients
Healthsource of Ohio Inc Current Accepting new patients
Healthsource of Ohio, Inc. Past Accepting new patients
Healthsource of Ohio, Inc. Past Accepting new patients
Healthsource of Ohio Inc Past Accepting new patients
Healthsource of Ohio Inc Past Accepting new patients
Healthsource of Ohio, Inc. Past Accepting new patients

Locations

2055 Hospital Dr
Ste 130
Batavia, OH 45103
Phone (513) 732-0700

1341 Clough Pike
#150
Batavia, OH 45103
Phone (513) 732-5082

4627 Aicholtz Rd
Cincinnati, OH 45244
Phone (513) 753-2820

424 Wards Corner Rd
Ste 200
Loveland, OH 45140
Phone (513) 707-4041

455 Wards Corner Rd
Ste 200
Loveland, OH 45140
Phone (513) 688-8580

150 Health Partners Cir
Mount Orab, OH 45154
Phone (937) 444-2514

218 Stern Rd
Seaman, OH 45679
Phone (937) 378-3633

Interoperability endpoints

  • Direct secure messaging: eduardo.santosdmd.p1@direct.hsohio.nextgenshare.com

Organizations & group practices 19

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.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1685577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732579200000",
    "number": "1366135618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "424 WARDS CORNER RD STE 200",
            "city": "LOVELAND",
            "state": "OH",
            "postal_code": "451406966",
            "telephone_number": "513-707-4041",
            "fax_number": "513-576-1020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 HEALTH PARTNERS CIR",
            "city": "MOUNT ORAB",
            "state": "OH",
            "postal_code": "451548610",
            "telephone_number": "937-444-2514",
            "fax_number": "937-444-8012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTOS",
        "first_name": "EDUARDO",
        "middle_name": "JULIAN",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-01",
        "last_updated": "2024-11-26",
        "certification_date": "2024-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30.027231",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0079795",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Orab, OH

Sources for this page

Verify at the official NPI Registry.