Individual provider Active NPI

Maria Teresa Santana, DDS

  • General Practice Dentistry
  • Round Rock, TX
National Provider Identifier
1417038613
Registry record updated Feb 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
26089 Issued in TX
Practice address
1401 S Interstate 35 Ste 230
Round Rock, TX 78664-6600
Phone
(512) 310-1500
NPI assigned
Oct 17, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 12, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 54675 CA
General Practice Dentistry 1223G0001X 26089 TX Primary

Addresses

Primary practice location

1401 S Interstate 35 Ste 230
Round Rock, TX 78664-6600

Mailing address

1401 S Interstate 35 Ste 230
Round Rock, TX 78664-6600
Phone (415) 235-2579

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20160428002246 TX Order and Referring Only - DentistPractitioner - Dentist 1951600741

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
26089TXMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739318400000",
    "number": "1417038613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 S INTERSTATE 35 STE 230",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786646600",
            "telephone_number": "415-235-2579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 S INTERSTATE 35 STE 230",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786646600",
            "telephone_number": "512-310-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTANA",
        "first_name": "MARIA",
        "middle_name": "TERESA",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-17",
        "last_updated": "2025-02-12",
        "certification_date": "2025-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "54675",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "26089",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Round Rock, TX

Sources for this page

Verify at the official NPI Registry.