Individual provider Active NPI

Francisco P. San Nicolas Jr., DMD

  • Pediatric Dentistry
  • Hagatra, GU
National Provider Identifier
1457582991
Registry record updated Jul 31, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
D-992 Issued in GU
Practice address
222 Chalan Santo Papa St.
The Reflection Center Ste. 301
Hagatra, GU 96910
Phone
(671) 477-6235
Fax
(671) 477-6237
NPI assigned
Jul 31, 2009
Last updated
Jul 31, 2009By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 31, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X D-992 GU Primary

Addresses

Primary practice location

222 Chalan Santo Papa St.
The Reflection Center Ste. 301
Hagatra, GU 96910

Mailing address

222 Chalan Santo Papa St.
The Reflection Center Ste. 301
Hagatra, GU 96910
Phone (671) 477-6235

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
D-992GUMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
The Pediatric Dental Center Pediatric Dentistry Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1248998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248998400000",
    "number": "1457582991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 CHALAN SANTO PAPA ST.",
            "address_2": "THE REFLECTION CENTER STE. 301",
            "city": "HAGATRA",
            "state": "GU",
            "postal_code": "96910",
            "telephone_number": "671-477-6235",
            "fax_number": "671-477-6237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 CHALAN SANTO PAPA ST.",
            "address_2": "THE REFLECTION CENTER STE. 301",
            "city": "HAGATRA",
            "state": "GU",
            "postal_code": "96910",
            "telephone_number": "671-477-6235",
            "fax_number": "671-477-6237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAN NICOLAS",
        "first_name": "FRANCISCO",
        "middle_name": "P.",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-07-31",
        "last_updated": "2009-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "GU",
            "license": "D-992",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2009; 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.