Provider Demographics
NPI:1083637573
Name:SANTELLI, JAMES EUGENE JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:EUGENE
Last Name:SANTELLI
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:OYSTER BAY
Mailing Address - State:NY
Mailing Address - Zip Code:11771-2215
Mailing Address - Country:US
Mailing Address - Phone:516-922-6601
Mailing Address - Fax:
Practice Address - Street 1:33 W MAIN ST
Practice Address - Street 2:
Practice Address - City:OYSTER BAY
Practice Address - State:NY
Practice Address - Zip Code:11771-2215
Practice Address - Country:US
Practice Address - Phone:516-922-6601
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0339011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice