Provider Demographics
NPI:1265548234
Name:SANTIAGO-COIRO, VICTORIA LYNN (DMD)
Entity type:Individual
Prefix:DR
First Name:VICTORIA
Middle Name:LYNN
Last Name:SANTIAGO-COIRO
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5355 PINEHURST PARK DR APT 197
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28211-5306
Mailing Address - Country:US
Mailing Address - Phone:908-910-6074
Mailing Address - Fax:
Practice Address - Street 1:1020 LEE ANN DR NE
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28025-2911
Practice Address - Country:US
Practice Address - Phone:980-370-2894
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2025-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC108761223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice