Individual provider Active NPI

Noemar Santiago

  • General Practice Dentistry
  • Cidra, PR
National Provider Identifier
1750419206
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
1788 Issued in PR
Practice address
15 Calle Lago
Urb Campolago
Cidra, PR 00739-9358
Phone
(787) 257-3969
Fax
(787) 257-3969
NPI assigned
Feb 28, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 1788 PR Primary

Addresses

Primary practice location

15 Calle Lago
Urb Campolago
Cidra, PR 00739-9358

Mailing address

15 Calle Lago
Urb Campolago
Cidra, PR 00739-9358
Phone (787) 257-3969

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
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
I20161130002029 PR Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 9931489333

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1750419206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 CALLE LAGO",
            "address_2": "URB CAMPOLAGO",
            "city": "CIDRA",
            "state": "PR",
            "postal_code": "007399358",
            "telephone_number": "787-257-3969",
            "fax_number": "787-257-3969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 CALLE LAGO",
            "address_2": "URB CAMPOLAGO",
            "city": "CIDRA",
            "state": "PR",
            "postal_code": "007399358",
            "telephone_number": "787-257-3969",
            "fax_number": "787-257-3969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTIAGO",
        "first_name": "NOEMAR",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PR",
            "license": "1788",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cidra, PR

Sources for this page

Verify at the official NPI Registry.