Individual provider Active NPI

David Santiago, DMD, MDS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • San Juan, PR
National Provider Identifier
1750534863
Registry record updated Nov 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
1520 Issued in PR
Practice address
1311 Ave Americo Miranda
San Juan, PR 00921-2118
Phone
(787) 792-2850
Fax
(787) 725-3440
NPI assigned
Nov 3, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 3, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 1520 PR Primary

Addresses

Primary practice location

1311 Ave Americo Miranda
San Juan, PR 00921-2118

Mailing address

1311 Ave Americo Miranda
San Juan, PR 00921-2118
Phone (787) 792-2850

Other identifiers 1

IdentifierTypeStateIssuer
1520OtherPRLIC

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

LicenseStateTypeSpecialty
1520PRMDSpeech-Language Assistant

NPI Registry JSON

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

{
    "created_epoch": "1225670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225670400000",
    "number": "1750534863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1311 AVE AMERICO MIRANDA",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009212118",
            "telephone_number": "787-792-2850",
            "fax_number": "787-725-3440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1311 AVE AMERICO MIRANDA",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009212118",
            "telephone_number": "787-792-2850",
            "fax_number": "787-725-3440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTIAGO",
        "first_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "DMD, MDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-11-03",
        "last_updated": "2008-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "PR",
            "license": "1520",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LIC",
            "identifier": "1520",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.