1023032786 NPI number — JOHN N. SANTIN D.D.S., INC

Table of content: (NPI 1023032786)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1023032786 NPI number — JOHN N. SANTIN D.D.S., INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JOHN N. SANTIN D.D.S., INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
AKRON AREA ORAL AND MAXILLOFACIAL SURGERY ASSOCIATES
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1023032786
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3503 FORTUNA DR
Provider Second Line Business Mailing Address:
SUITE 1
Provider Business Mailing Address City Name:
AKRON
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44312-5285
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
330-645-6637
Provider Business Mailing Address Fax Number:
330-645-6688

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3503 FORTUNA DR
Provider Second Line Business Practice Location Address:
SUITE 1
Provider Business Practice Location Address City Name:
AKRON
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44312-5285
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
330-645-6637
Provider Business Practice Location Address Fax Number:
330-645-6688
Provider Enumeration Date:
07/27/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
SANTIN
Authorized Official First Name:
JOHN
Authorized Official Middle Name:
N
Authorized Official Title or Position:
ORAL AND MAXILLOFACIAL SURGEON
Authorized Official Telephone Number:
330-645-6637

Provider Taxonomy Codes

  • Taxonomy code: 1223S0112X , with the licence number:  16792 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)