Healthcare Provider Details

I. General information

NPI: 1144154618
Provider Name (Legal Business Name): RAUL SANTANA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/10/2026
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4351 GARDEN CITY DR
LANDOVER MD
20785-2223
US

IV. Provider business mailing address

708 DOWNS DR
SILVER SPRING MD
20904-2022
US

V. Phone/Fax

Practice location:
  • Phone: 301-459-3650
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: