Gerardo F Santana

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019034453 Issued in IL

Practice address

3212 Court St
Pekin, IL 61554-6209

Phone

(309) 347-8590

NPI assigned

Apr 7, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1680825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692748800000",
    "number": "1770278533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "446 E 7TH ST",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620022436",
            "telephone_number": "813-500-2341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3212 COURT ST",
            "city": "PEKIN",
            "state": "IL",
            "postal_code": "615546209",
            "telephone_number": "309-347-8590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTANA",
        "first_name": "GERARDO",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-04-07",
        "last_updated": "2023-08-23",
        "certification_date": "2023-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019034453",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine Ruskusky
• Jeffrey Robert Ruskusky, D.P.M.
• John L Ruskusky, D.P.M.
• Alicia R. Saal
• Ryan Sangalli, PHARM D
• Leanard Sanny Daoang Santos, CRNA
• Lisa A Sathoff, BA
• Larisa Savage, APN, CNM
• Mandi J Sawlaw, SLP
• Muslim Sayed, PHARMD

• General Practice Dentistry in Pekin, IL
• Providers in Pekin, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2023; 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.