Active NPI
Angel R Santiago, D.M.D.M.S.
- Periodontics
- Fort Myers, FL
National Provider Identifier
1376656942
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- DN16440
- Practice address
- 6323 Corporate CT
Suite B
Fort Myers, FL 33919-3506 - Phone
- (239) 482-3343
- Fax
- (239) 482-3462
- NPI assigned
- Aug 16, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Periodontics | 1223P0300X | DN16440 | FL | Primary |
Addresses
Primary practice location
6323 Corporate CT
Suite B
Fort Myers, FL 33919-3506
Mailing address
6323 Corporate CT
Suite B
Fort Myers, FL 33919-3506
Phone (239) 482-3343
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN16440 | FL | MD | Periodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155686400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1376656942",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6323 CORPORATE CT",
"address_2": "SUITE B",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339193506",
"telephone_number": "239-482-3343",
"fax_number": "239-482-3462"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6323 CORPORATE CT",
"address_2": "SUITE B",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339193506",
"telephone_number": "239-482-3343",
"fax_number": "239-482-3462"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANTIAGO",
"first_name": "ANGEL",
"middle_name": "R",
"credential": "D.M.D.M.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "FL",
"license": "DN16440",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Myers, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.