Active NPI
Shea Nicole Santos, DDS
- Dentist
- Temple, TX
National Provider Identifier
1710548656
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 35192
- Practice address
- 7410 W Adams Ave
Temple, TX 76502-5891 - Phone
- (254) 406-6066
- NPI assigned
- Jun 21, 2019
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 35192 | TX | Primary |
Addresses
Primary practice location
7410 W Adams Ave
Temple, TX 76502-5891
Mailing address
105 N Austin Ave Apt 1102
Georgetown, TX 78626-4240
Phone (682) 365-2958
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 |
|---|---|---|---|
| 35192 | TX | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1561075200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1561075200000",
"number": "1710548656",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "105 N AUSTIN AVE APT 1102",
"city": "GEORGETOWN",
"state": "TX",
"postal_code": "786264240",
"telephone_number": "682-365-2958"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7410 W ADAMS AVE",
"city": "TEMPLE",
"state": "TX",
"postal_code": "765025891",
"telephone_number": "254-406-6066"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANTOS",
"first_name": "SHEA",
"middle_name": "NICOLE",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-06-21",
"last_updated": "2019-06-21",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "35192",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Temple, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.