Kimberly Jana Santiago, DDS, PS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

10284 Issued in WA

Practice address

22619 SE 64TH PL
Ste 120
Issaquah, WA 98027-5342

Phone

(425) 392-4888

Fax

(425) 392-8321

NPI assigned

Mar 28, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

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": "1175040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1811016223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1116 YAKIMA AVE S",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981443126",
            "telephone_number": "206-323-9114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22619 SE 64TH PL",
            "address_2": "STE 120",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980275342",
            "telephone_number": "425-392-4888",
            "fax_number": "425-392-8321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTIAGO",
        "first_name": "KIMBERLY",
        "middle_name": "JANA",
        "name_prefix": "Dr.",
        "credential": "DDS, PS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "10284",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Sander, LMHC INTERN
• Laura Sanderson, CNM
• Barry Vaughn Sandoval, MD
• Sandpoint Clinic Pharmacy Inc
• Jessica M. Sankey, OTR/L, CHT
• Susana Santiago
• Vina Sargent I, MA, CCC-SLP
• Kimberly Blake Satenberg
• Holly Reimei Nikko Sato, MD
• Michael J Sato, OD

• General Practice Dentistry in Issaquah, WA
• Providers in Issaquah, WA by specialty
• General Practice Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.