Ivan Jonathan Santos, DDS in Lakeside, CA - Medicare Dentist Provider

Ivan Jonathan Santos, DDS is a medicare enrolled "Dentist" provider in Lakeside, California. His current practice location is 12110 Woodside Ave, Lakeside, California. You can reach out to his office (for appointments etc.) via phone at (619) 443-0444.

Ivan Jonathan Santos is licensed to practice in California (license number 100036) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1659730182.

Contact Information

	Ivan Jonathan Santos, DDS
	12110 Woodside Ave, Lakeside, CA 92040-3012
	(619) 443-0444
	(619) 443-0050

Map and Direction

Healthcare Provider's Profile

Full Name	Ivan Jonathan Santos
Gender	Male
Speciality	Dentist
Location	12110 Woodside Ave, Lakeside, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1659730182
Provider Enumeration Date: 02/11/2016
Last Update Date: 02/11/2016

Medicare PECOS Information:

PECOS PAC ID: 9739510173
Enrollment ID: I20200519000622

Medical Identifiers

Medical identifiers for Ivan Jonathan Santos such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1659730182	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
122300000X	Dentist	100036 (California)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Ivan Jonathan Santos allows following entities to bill medicare on his behalf.

Entity Name	Arthur Santos Dds Corp
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1770940637 PECOS PAC ID: 7517398209 Enrollment ID: O20200513001555

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ivan Jonathan Santos is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Ivan Jonathan Santos, DDS 6833 Fashion Hills Blvd, San Diego, CA 92111-7651 Ph: () -	Ivan Jonathan Santos, DDS 12110 Woodside Ave, Lakeside, CA 92040-3012 Ph: (619) 443-0444

Reviews and Comments

Dentist in Lakeside, CA

Dr. Diana Laree Cluff, DMD Dentist Medicare: Not Enrolled in Medicare Practice Location: 9447 Winter Gardens Blvd, Lakeside, CA 92040 Phone: 619-443-3948
Burch Lee Blackstock, D.D.S Dentist Medicare: Not Enrolled in Medicare Practice Location: 12110 Woodside Ave, Lakeside, CA 92040 Phone: 619-443-0444 Fax: 619-443-0050
Dr. Cesar Ayala, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 12110 Woodside Ave, Lakeside, CA 92040 Phone: 619-334-8743
Dr. Arnold I Cutler, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 9927 Channel Rd, Lakeside, CA 92040 Phone: 619-561-3307 Fax: 619-561-3804
Dr. David Robert Russell, DDS Dentist Medicare: Medicare Enrolled Practice Location: 8334 Winter Gardens Blvd, Lakeside, CA 92040 Phone: 619-443-7898 Fax: 619-443-4404
Dr. Don Richard Graham, D.D.S. Dentist Medicare: Not Enrolled in Medicare Practice Location: 9710 Winter Gardens Blvd, Suite #c, Lakeside, CA 92040 Phone: 619-443-8447 Fax: 619-443-5450
Mrs. Ana I Cluff, D.D.S. Dentist Medicare: Not Enrolled in Medicare Practice Location: 9447 Winter Gardens Blvd, Lakeside, CA 92040 Phone: 619-443-3948 Fax: 619-443-3938

Ivan Jonathan Santos, DDS - Medicare Dentist in Lakeside, CA