Individual provider Active NPI

Victor De Los Santos, D,D.S.

  • General Practice Dentistry
  • Arcadia, CA
National Provider Identifier
1710019385
Registry record updated May 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
36534 Issued in CA
Practice address
1035 W Huntington Dr Ste B
Arcadia, CA 91007-6536
Phone
(626) 574-2154
Fax
(626) 574-2970
NPI assigned
Mar 9, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 18, 2022

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 36534 CA Primary

Addresses

Primary practice location

1035 W Huntington Dr Ste B
Arcadia, CA 91007-6536

Mailing address

3712 Atlantic Ave C
Long Beach, CA 90807-3542
Phone (562) 426-1298

Other practice location 1

1919 Beverly Blvd Ste A
Los Angeles, CA 90057-2401
Phone (213) 484-2919

Other practice location 2

3712 Atlantic Ave Ste C
Long Beach, CA 90807-3542
Phone (562) 426-1298

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151217001355 CA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 8325349277

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Victor de Los Santos D.D.S. Inc 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.

NPI Registry JSON

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652832000000",
    "number": "1710019385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3712 ATLANTIC AVE C",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908073542",
            "telephone_number": "562-426-1298",
            "fax_number": "562-426-4131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1035 W HUNTINGTON DR STE B",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "910076536",
            "telephone_number": "626-574-2154",
            "fax_number": "626-574-2970"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1919 Beverly Blvd Ste A",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900572401",
            "country_code": "US",
            "telephone_number": "213-484-2919",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3712 Atlantic Ave Ste C",
            "address_purpose": "LOCATION",
            "city": "Long Beach",
            "state": "CA",
            "postal_code": "908073542",
            "country_code": "US",
            "telephone_number": "562-426-1298",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DE LOS SANTOS",
        "first_name": "VICTOR",
        "name_prefix": "Dr.",
        "credential": "D,D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-09",
        "last_updated": "2022-05-18",
        "certification_date": "2022-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "36534",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arcadia, CA

Sources for this page

Verify at the official NPI Registry.