Active NPI
Nicholas Michael Santarsiero, D.M.D.
- General Practice Dentistry
- Blakely, PA
National Provider Identifier
1659575967
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DS037183
- Practice address
- 119 Main St
Blakely, PA 18447-1291 - Phone
- (570) 382-3627
- Fax
- (570) 382-8116
- NPI assigned
- Jun 12, 2007
- Sex
- Male
- 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 | DS037183 | PA | Primary |
Addresses
Primary practice location
119 Main St
Blakely, PA 18447-1291
Mailing address
119 Main St
Blakely, PA 18447-1291
Phone (570) 382-3627
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 |
|---|---|---|---|
| DS037183 | PA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Santarsiero Family Dental LLC | General Practice | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- General Practice Dentistry
- Blakely, PA
- NPI 1760807580
General Practice
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181606400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1432771200000",
"number": "1659575967",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "119 MAIN ST",
"city": "BLAKELY",
"state": "PA",
"postal_code": "184471291",
"telephone_number": "570-382-3627",
"fax_number": "570-382-8116"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "119 MAIN ST",
"city": "BLAKELY",
"state": "PA",
"postal_code": "184471291",
"telephone_number": "570-382-3627",
"fax_number": "570-382-8116"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANTARSIERO",
"first_name": "NICHOLAS",
"middle_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-06-12",
"last_updated": "2015-05-28",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "PA",
"license": "DS037183",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Blakely, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.