Provider Demographics
NPI:1821152232
Name:SANTOS-FIGUEROA, LUIS J (DMD)
Entity Type:Individual
Prefix:DR
First Name:LUIS
Middle Name:J
Last Name:SANTOS-FIGUEROA
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7113 ALTIS WAY, APT 215
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32836-6860
Mailing Address - Country:US
Mailing Address - Phone:561-307-6381
Mailing Address - Fax:
Practice Address - Street 1:5449 S SEMORAN BLVD, STE 19B
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32822-1778
Practice Address - Country:US
Practice Address - Phone:407-858-1479
Practice Address - Fax:407-249-4472
Is Sole Proprietor?:No
Enumeration Date:2006-12-20
Last Update Date:2023-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR24341223G0001X
FLDN194001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL006325900Medicaid
FL06325900Medicaid