Provider Demographics
NPI:1235498478
Name:SANTOS, MARIA (RDHAP)
Entity Type:Individual
Prefix:MS
First Name:MARIA
Middle Name:
Last Name:SANTOS
Suffix:
Gender:F
Credentials:RDHAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1633 MATCHLEAF AVE
Mailing Address - Street 2:
Mailing Address - City:HACIENDA HTS
Mailing Address - State:CA
Mailing Address - Zip Code:91745-3651
Mailing Address - Country:US
Mailing Address - Phone:323-333-8817
Mailing Address - Fax:
Practice Address - Street 1:1633 MATCHLEAF AVE
Practice Address - Street 2:
Practice Address - City:HACIENDA HTS
Practice Address - State:CA
Practice Address - Zip Code:91745-3651
Practice Address - Country:US
Practice Address - Phone:323-333-8817
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-09
Last Update Date:2012-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHAP 403124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist