Active NPI
Iris M Santos, DMD
- General Practice Dentistry
- Marianna, FL
National Provider Identifier
1487875233
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 1455
- Practice address
- 4126 Independent Dr
Marianna, FL 32448-4023 - Phone
- (850) 394-4907
- NPI assigned
- May 1, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 1455 | PR | Primary |
Addresses
Primary practice location
4126 Independent Dr
Marianna, FL 32448-4023
Mailing address
403 E 11TH St Ste 140
Panama City, FL 32401-3409
Phone (850) 747-5599
Other practice location 1
5336 10th St
Malone, FL 32445-3429
Phone (850) 569-2053
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1455 | PR | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177977600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1682899200000",
"number": "1487875233",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "403 E 11TH ST STE 140",
"city": "PANAMA CITY",
"state": "FL",
"postal_code": "324013409",
"telephone_number": "850-747-5599",
"fax_number": "850-872-4131"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4126 INDEPENDENT DR",
"city": "MARIANNA",
"state": "FL",
"postal_code": "324484023",
"telephone_number": "850-394-4907"
}
],
"practiceLocations": [
{
"address_1": "5336 10th St",
"address_purpose": "LOCATION",
"city": "Malone",
"state": "FL",
"postal_code": "324453429",
"country_code": "US",
"telephone_number": "850-569-2053",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SANTOS",
"first_name": "IRIS",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-01",
"last_updated": "2023-05-01",
"certification_date": "2023-05-01",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "PR",
"license": "1455",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Marianna, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.