Individual provider Active NPI

Jose E Delos Santos, DDS

  • Dentist
  • Surprise, AZ
National Provider Identifier
1447649454
Registry record updated Jan 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D06750 Issued in AZ
Practice address
15717 W Jenan Dr
Surprise, AZ 85379-1026
Phone
(623) 399-6215
NPI assigned
Jan 14, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 14, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D06750 AZ Primary

Addresses

Primary practice location

15717 W Jenan Dr
Surprise, AZ 85379-1026

Mailing address

2105 N Citrus Rd
Goodyear, AZ 85395-9204
Phone (623) 853-0304

Other names 1

  • Dr. Jose Eu Delos Santos Other name

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

LicenseStateTypeSpecialty
D06750AZMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1421193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421193600000",
    "number": "1447649454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2105 N CITRUS RD",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853959204",
            "telephone_number": "623-853-0304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15717 W JENAN DR",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853791026",
            "telephone_number": "623-399-6215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELOS SANTOS",
        "first_name": "JOSE",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-01-14",
        "last_updated": "2015-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "D06750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOSE",
            "last_name": "DELOS SANTOS",
            "middle_name": "EU",
            "prefix": "DR.",
            "credential": "DDS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Surprise, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.