Provider Demographics
NPI:1891126777
Name:STEPHANIE L. SANTOS, DDS, PC
Entity Type:Organization
Organization Name:STEPHANIE L. SANTOS, DDS, PC
Other - Org Name:SMILE BY DESIGN, A DIVISION OF ATLANTIC DENTAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:SANTOS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:757-499-9639
Mailing Address - Street 1:281 INDEPENDENCE BLVD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-2986
Mailing Address - Country:US
Mailing Address - Phone:757-499-9639
Mailing Address - Fax:757-490-0808
Practice Address - Street 1:281 INDEPENDENCE BLVD
Practice Address - Street 2:SUITE 210
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-2986
Practice Address - Country:US
Practice Address - Phone:757-499-9639
Practice Address - Fax:757-490-0808
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ATLANTIC DENTAL CARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-12-03
Last Update Date:2014-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401008019122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty