Individual provider Active NPI

Frank H Sargent, DDS MS

  • Endodontics
  • Sioux City, IA
National Provider Identifier
1003996604
Registry record updated Jun 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
06889 Issued in IA
Practice address
2910 Hamilton Blvd
Suite 101
Sioux City, IA 51104-2423
Phone
(712) 255-8017
Fax
(712) 252-9748
NPI assigned
Oct 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 06889 IA Primary

Addresses

Primary practice location

2910 Hamilton Blvd
Suite 101
Sioux City, IA 51104-2423

Mailing address

2910 Hamilton Blvd
Suite 101
Sioux City, IA 51104-2423
Phone (712) 255-8017

Other identifiers 1

IdentifierTypeStateIssuer
0215475MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130614000090 IA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 9537308994

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
06889IAMDEndodontist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245024000000",
    "number": "1003996604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2910 HAMILTON BLVD",
            "address_2": "SUITE 101",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "511042423",
            "telephone_number": "712-255-8017",
            "fax_number": "712-252-9748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2910 HAMILTON BLVD",
            "address_2": "SUITE 101",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "511042423",
            "telephone_number": "712-255-8017",
            "fax_number": "712-252-9748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SARGENT",
        "first_name": "FRANK",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "DDS MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2009-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "IA",
            "license": "06889",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0215475",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux City, IA

Sources for this page

Verify at the official NPI Registry.