Individual provider Active NPI

Zachary Robert Santoro, DMD

  • Public Health Dentistry
  • Alton, IL
National Provider Identifier
1508548793
Registry record updated Aug 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health DentistryTaxonomy code 1223D0001X
License
019.033858 Issued in IL
Practice address
2800 College Ave
Alton, IL 62002-4742
Phone
(618) 474-7000
NPI assigned
Aug 7, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health Dentistry 1223D0001X 019.033858 IL Primary

Addresses

Primary practice location

2800 College Ave
Alton, IL 62002-4742

Mailing address

3238 Charlotte CT Apt C
Alton, IL 62002-4894
Phone (239) 961-1265

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
019.033858ILMDPublic Health Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Illinois University Edwardsville School of Dental Medicine PastSince Aug 13, 2023 Accepting new patients
Southern Illinois University Edwardsville School of Dental Medicine PastSince Aug 13, 2023 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1691366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691366400000",
    "number": "1508548793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3238 CHARLOTTE CT APT C",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620024894",
            "telephone_number": "239-961-1265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 COLLEGE AVE",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620024742",
            "telephone_number": "618-474-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTORO",
        "first_name": "ZACHARY",
        "middle_name": "ROBERT",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-08-07",
        "last_updated": "2023-08-07",
        "certification_date": "2023-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223D0001X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Public Health",
            "state": "IL",
            "license": "019.033858",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alton, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 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.