Individual provider Active NPI

Remedios Josefina Santos, DMD

  • General Practice Dentistry
  • Jacksonville, FL
National Provider Identifier
1821144213
Registry record updated Nov 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN9719 Issued in FL
Practice address
3704 Heath Road
Jacksonville, FL 32277-2045
Phone
(904) 743-6380
Fax
(904) 744-5350
NPI assigned
Jan 26, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN9719 FL Primary
General Practice Dentistry 1223G0001X D2060 ID

Addresses

Primary practice location

3704 Heath Road
Jacksonville, FL 32277-2045

Mailing address

9000 Golfside Drive
Suite B
Jacksonville, FL 32256-7793
Phone (904) 367-1722

Other names 1

  • Remedios Josefina Santos Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20160401001657 FL Order and Referring Only - DentistPractitioner - Dentist 1254638406

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN9719FLMDGeneral Practice Dentistry
D2060IDMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Smilecare Dental Associates PA 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": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288828800000",
    "number": "1821144213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9000 GOLFSIDE DRIVE",
            "address_2": "SUITE B",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322567793",
            "telephone_number": "904-367-1722",
            "fax_number": "904-367-1739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3704 HEATH ROAD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322772045",
            "telephone_number": "904-743-6380",
            "fax_number": "904-744-5350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTOS",
        "first_name": "REMEDIOS",
        "middle_name": "JOSEFINA",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-26",
        "last_updated": "2010-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN9719",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "D2060",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REMEDIOS",
            "last_name": "SANTOS",
            "middle_name": "JOSEFINA",
            "credential": "DMD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.