Lucely Santillan
Dentist, Pediatric Dentistry in Dallas, TX. Individual provider (NPI-1).
NPI number1962085704
StatusActive
Last updated in NPPESJan 13, 2026
Details
- NPI
- 1962085704
- Entity type
- Individual (NPI-1)
- Name
- Lucely Santillan
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Apr 29, 2021
- Certification date
- Jan 13, 2026
- Last updated
- Jan 13, 2026
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223P0221X | Dentist, Pediatric Dentistry | 37665 | TX | Yes |
Practice location
1935 Medical District DrDallas, TX 75235-7701
Phone 214-456-2735
Mailing address
4880 N President George Bush Hwy # 104Garland, TX 75040-2742
Phone 978-635-2217
Other practice locations
4880 N President George Bush Hwy # 104
Garland, TX 75040-2742
Garland, TX 75040-2742
Phone 972-364-7472
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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