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

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



Healthcare Provider's Profile

Full NameIvan Jonathan Santos
GenderMale
SpecialityDentist
Location12110 Woodside Ave, Lakeside, California
Accepts Medicare AssignmentsMedicare 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.
IdentifierTypeStateIssuer
1659730182NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
122300000XDentist 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 NameArthur Santos Dds Corp
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1770940637
PECOS PAC ID: 7517398209
Enrollment ID: O20200513001555

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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 AddressPractice 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

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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

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