Gregory A. Santarelli, DDS SC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

5188015 Issued in WI

Practice address

5017 Green Bay Rd
Suite 138
Kenosha, WI 53144-1782

Phone

(262) 654-6770

Fax

(262) 654-6727

NPI assigned

Nov 1, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective May 29, 2014 through May 29, 2028

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Gregory a. Santarelli DDS SC

  • Oral and Maxillofacial Surgery (Dentist)
  • Kenosha, WI
  • NPI 1083891261
  NPD (past)
• Oral Surgery Associates of Milwaukee

  • Oral and Maxillofacial Surgery (Dentist)
  • Wauwatosa, WI
  • NPI 1720172992
  NPD (past)
• Oral Surgery Associates of Milwaukee SC

  • Oral and Maxillofacial Surgery (Dentist)
  • Mequon, WI
  • NPI 1477647832
  NPD (past)

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215648000000",
    "number": "1578640488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5017 GREEN BAY RD",
            "address_2": "SUITE 138",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531441782",
            "telephone_number": "262-654-6770",
            "fax_number": "262-654-6727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5017 GREEN BAY RD",
            "address_2": "SUITE 138",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531441782",
            "telephone_number": "262-654-6770",
            "fax_number": "262-654-6727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTARELLI",
        "first_name": "GREGORY",
        "middle_name": "A.",
        "credential": "DDS SC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2008-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "WI",
            "license": "5188015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Manuel Alejandro Sanchez, PHYSICIAN ASSISTANT
• Lawrence C Sandberg, PT
• Sydney Sanders
• Marie Lynn Sands, PTA
• Daniel R Santarelli, DDS
• James L Santarelli, DDS
• James M Santarelli, MD
• Anna Maria Santelle, MA CCCSLP
• Charles Santilukka, D.O.
• Gianna Santoro, LPN

• Oral and Maxillofacial Surgery (Dentist) in Kenosha, WI
• Providers in Kenosha, WI by specialty
• Oral and Maxillofacial Surgery (Dentist) in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.