Individual provider Active NPI

Giancarlo Santos, D.D.S

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Round Rock, TX
National Provider Identifier
1477958908
Registry record updated Aug 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
31700 Issued in TX
Practice address
1500 S Aw Grimes Blvd Ste 190
Round Rock, TX 78664-7843
Phone
(512) 255-5900
NPI assigned
Oct 27, 2014
Last updated
Aug 3, 2017By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 3, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 31700 TX Primary

Addresses

Primary practice location

1500 S Aw Grimes Blvd Ste 190
Round Rock, TX 78664-7843

Mailing address

1500 S. Aw Grimes Blvd
Ste 190
Round Rock, TX 78664
Phone (412) 648-8419

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
I20170908000928 TX Order and Referring Only - DentistPractitioner - Dentist 8426321720

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
31700TXMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Specialty Dental Management LLC Orthodontics and Dentofacial Orthopedics PastSince Mar 13, 2022 Accepting new patients
Sing Orthodontics PC Orthodontics and Dentofacial Orthopedics PastSince Jun 26, 2022 Accepting new patients

Organizations & group practices 2

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": "1414368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1501718400000",
    "number": "1477958908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 S. AW GRIMES BLVD",
            "address_2": "STE 190",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "78664",
            "telephone_number": "412-648-8419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 S AW GRIMES BLVD STE 190",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786647843",
            "telephone_number": "512-255-5900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTOS",
        "first_name": "GIANCARLO",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-10-27",
        "last_updated": "2017-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "TX",
            "license": "31700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Round Rock, TX

Sources for this page

Verify at the official NPI Registry.