Provider Demographics
NPI:1326473232
Name:SANTOS, TANIA RANGEL (DDS)
Entity Type:Individual
Prefix:DR
First Name:TANIA
Middle Name:RANGEL
Last Name:SANTOS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4713 NW 9TH PL
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33178-1404
Mailing Address - Country:US
Mailing Address - Phone:305-807-4447
Mailing Address - Fax:305-406-2442
Practice Address - Street 1:9831 NW 58TH ST
Practice Address - Street 2:SUITE 138
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33178-2713
Practice Address - Country:US
Practice Address - Phone:305-456-5494
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-10
Last Update Date:2016-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN20390122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist