Active NPI
Jaciel Santiago, DDS
- Dentist
- Caguas, PR
National Provider Identifier
1861592990
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 2354
- Practice address
- Ave Bairoa
Aa-6
Caguas, PR 00725 - Phone
- (787) 703-0710
- Fax
- (787) 703-0710
- NPI assigned
- Sep 25, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 2354 | PR | Primary |
Addresses
Primary practice location
Ave Bairoa
Aa-6
Caguas, PR 00725
Mailing address
100 Espiritu Santo Final Cond Santa Cecilia Torre 2
Apto 102
Caguas, PR 00725
Phone (787) 479-4470
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160411001954 | PR | Order and Referring Only - Other (Physician) | 0446558217 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2354 | PR | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159142400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1539907200000",
"number": "1861592990",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 ESPIRITU SANTO FINAL COND SANTA CECILIA TORRE 2",
"address_2": "APTO 102",
"city": "CAGUAS",
"state": "PR",
"postal_code": "00725",
"telephone_number": "787-479-4470",
"fax_number": "787-703-0710"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "AVE BAIROA",
"address_2": "AA-6",
"city": "CAGUAS",
"state": "PR",
"postal_code": "00725",
"telephone_number": "787-703-0710",
"fax_number": "787-703-0710"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANTIAGO",
"first_name": "JACIEL",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-25",
"last_updated": "2018-10-19",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "PR",
"license": "2354",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Caguas, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2018; 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.