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General NPI Number Information
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NPI Number | 1811016223
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Entity Type | Individual
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Provider Name | KIMBERLY JANA SANTIAGO DDS, PS
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Gender | Female
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Dates
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Enumeration Date | 03/28/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 22619 SE 64TH PL STE 120
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City | ISSAQUAH
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State | WA
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Zip | 98027-5342
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Country | US
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Telephone | 425-392-4888
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Fax | 425-392-8321
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Provider Business Mailing Address
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Address Line | 1116 YAKIMA AVE S
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City | SEATTLE
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State | WA
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Zip | 98144-3126
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Country | US
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Telephone | 206-323-9114
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 10284
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License Number State | WA
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