Individual provider Active NPI

Carmen Aixa Santa, D.M.D.

  • Endodontics
  • San Juan, PR
National Provider Identifier
1447301445
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
1318 Issued in PR
Practice address
430 Calle San Claudio
Urb. Sagrado Corazon
San Juan, PR 00926-4222
Phone
(787) 758-2525
NPI assigned
Jan 16, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 1318 PR Primary

Addresses

Primary practice location

430 Calle San Claudio
Urb. Sagrado Corazon
San Juan, PR 00926-4222

Mailing address

60 Ave Winston Churchill
Apt. 1904
San Juan, PR 00926-6704
Phone (787) 761-4493

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
I20160405001189 PR Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 8820395999

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1318PRMDEndodontist

NPI Registry JSON

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1447301445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 AVE WINSTON CHURCHILL",
            "address_2": "APT. 1904",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009266704",
            "telephone_number": "787-761-4493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 CALLE SAN CLAUDIO",
            "address_2": "URB. SAGRADO CORAZON",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009264222",
            "telephone_number": "787-758-2525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTA",
        "first_name": "CARMEN",
        "middle_name": "AIXA",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "PR",
            "license": "1318",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.