MEDICARE: DR. REINALDO LASANTA-GARCIA DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	019.028164	IL
2	1223G0001X	General Practice Dentistry	9082	NC
3	122300000X	Dentist	018001733	IL
4	1223G0001X	General Practice Dentistry	DN22426	FL

General Provider Information

NPI Number	:	1235360595
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. REINALDO LASANTA-GARCIA DMD

Provider Business Mailing Address
First Line	:	PO BOX 952066
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44193-0051
Country	:	US
Telephone Number	:	919-213-0505
Fax Number	:	919-213-0505

Provider Business Practice Location Address
First Line	:	3622 SHANNON RD STE 101
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27707-3771
Country	:	US
Telephone Number	:	919-213-0505
Fax Number	:	919-213-0505

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/05/2009
Last Update Date	:	03/23/2026

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