Healthcare Provider Details

I. General information

NPI: 1043301591
Provider Name (Legal Business Name): RICHARD SANTOS DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2006
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

817 FEDERAL STREET
CAMDEN NJ
08103
US

IV. Provider business mailing address

1 FEDERAL ST STE 200
CAMDEN NJ
08103-1088
US

V. Phone/Fax

Practice location:
  • Phone: 856-541-9811
  • Fax: 856-541-3340
Mailing address:
  • Phone: 848-288-6935
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number22DI02204001
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: