Individual provider Active NPI

Santine Harlock, D.D.S.

  • General Practice Dentistry
  • Ann Arbor, MI
National Provider Identifier
1760508154
Registry record updated Apr 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
17636 Issued in MI
Practice address
3100 W Liberty Rd Ste a
Ann Arbor, MI 48103-8724
Phone
(734) 663-6777
Fax
(734) 663-9820
NPI assigned
Mar 21, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2015

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 17636 MI Primary

Addresses

Primary practice location

3100 W Liberty Rd Ste a
Ann Arbor, MI 48103-8724

Mailing address

3100 W Liberty Rd Ste a
Ann Arbor, MI 48103-8724
Phone (734) 663-6777

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20170405002324 MI Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 8022336148

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
17636MIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Enspire Dental PLLC 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": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429660800000",
    "number": "1760508154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 W LIBERTY RD STE A",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481038724",
            "telephone_number": "734-663-6777",
            "fax_number": "734-663-9820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 W LIBERTY RD STE A",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481038724",
            "telephone_number": "734-663-6777",
            "fax_number": "734-663-9820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARLOCK",
        "first_name": "SANTINE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-21",
        "last_updated": "2015-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "17636",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.