Provider Demographics
NPI:1841188455
Name:SANTANA, JESSICA I (DDS)
Entity type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:
Last Name:SANTANA
Suffix:I
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16123 PIONEER BLVD SPC 28
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CA
Mailing Address - Zip Code:90650-0311
Mailing Address - Country:US
Mailing Address - Phone:702-249-9513
Mailing Address - Fax:
Practice Address - Street 1:11311 LA MIRADA BLVD STE C
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90604-2126
Practice Address - Country:US
Practice Address - Phone:562-944-2995
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-24
Last Update Date:2025-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1102441223D0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223D0001XDental ProvidersDentistDental Public Health