Mauro Pedrine Santamaria, DDS

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

10855 Issued in KY

Practice address

750 Morton Blvd
Hazard, KY 41701-9469

Phone

(606) 439-3557

Fax

(606) 439-1422

NPI assigned

Oct 26, 2022

Last updated

Apr 18, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Mauro Pedrine Santamaria Other name

Medicare fee-for-service enrollment

Enrolled in KY

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Kentucky Medical Services Foundation, Inc

  • Internal Medicine Physician
  • Lexington, KY
  • NPI 1326091448
  Medicare reassignment NPD
• University of Kentucky

  • Diagnostic Radiology Physician
  • Lexington, KY
  • NPI 1770771974
  Medicare reassignment NPD
• University of Kentucky

  dba UK College of Dentistry

  • Dentist
  • Lexington, KY
  • NPI 1306929385
  NPD

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

{
    "created_epoch": "1666742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744934400000",
    "number": "1790402113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1095 VETERANS DR OFFICE 406B",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405360305",
            "telephone_number": "443-563-7917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 MORTON BLVD",
            "city": "HAZARD",
            "state": "KY",
            "postal_code": "417019469",
            "telephone_number": "606-439-3557",
            "fax_number": "606-439-1422"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2195 Harrodsburg Rd Ste 175",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "405043523",
            "country_code": "US",
            "telephone_number": "859-323-8873",
            "fax_number": "859-323-7193",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEDRINE SANTAMARIA",
        "first_name": "MAURO",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-10-26",
        "last_updated": "2025-04-18",
        "certification_date": "2025-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KY",
            "license": "10855",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "10855",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "KY",
            "license": "10855",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MAURO",
            "last_name": "SANTAMARIA",
            "middle_name": "PEDRINE",
            "credential": "DDS, MS, PHD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Madison Mobelini Patrick, MSN, APRN, FNP
• Nathaniel Wayne Patrick
• Jenna Patton, MS,OT
• Marsha Patton
• Pediatric Associates (Pediatric Associates of Hazard)
• Tyler Pennington, FNP-C
• Peripheral Vascular Labs of Ky, Inc
• Amber Perkins
• Justin Wayne Perkins
• Perry County Ambulance Authority, Inc.

• Periodontics in Hazard, KY
• Providers in Hazard, KY by specialty
• Periodontics in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.