Individual provider Active NPI

Iris M Santos, DMD

  • General Practice Dentistry
  • Marianna, FL
National Provider Identifier
1487875233
Registry record updated May 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
1455 Issued in PR
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

Updated by the provider on May 1, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
1455PRMDGeneral 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.

Verify at the official NPI Registry.