Provider Demographics
NPI:1760976948
Name:SANTIN, RILEY JAMES (DDS)
Entity Type:Individual
Prefix:DR
First Name:RILEY
Middle Name:JAMES
Last Name:SANTIN
Suffix:
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 1:638 N WEBB RD STE 1
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68803-4057
Mailing Address - Country:US
Mailing Address - Phone:308-381-0167
Mailing Address - Fax:
Practice Address - Street 1:638 N WEBB RD STE 1
Practice Address - Street 2:
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68803-4057
Practice Address - Country:US
Practice Address - Phone:308-381-0167
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-20
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE74721223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice