NPIMap

Organization Active NPI

Sagisi DMD Inc

  • General Practice Dentistry
  • Palmdale, CA
National Provider Identifier
1013396423
Registry record updated May 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
63715 Issued in CA
Legal business name
SAGISI DMD INC
Practice address
38750 Trade Center Dr Ste J
Palmdale, CA 93551-3787
Phone
(661) 267-6400
NPI assigned
May 19, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 19, 2015

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

Authorized official

Name
Randall Sagisi, DMD
Title
President
Phone
(661) 267-6400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 63715 CA Primary

Addresses

Primary practice location

38750 Trade Center Dr Ste J
Palmdale, CA 93551-3787

Mailing address

38750 Trade Center Dr Ste J
Palmdale, CA 93551-3787
Phone (661) 267-6400

Other names 1

  • PRESTIGE DENTAL CARE Doing business as

National Provider Directory

National Provider Directory

Locations

38750 Trade Center Dr
Ste J
Palmdale, CA 93551
Phone (661) 267-6400

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1431993600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431993600000",
    "number": "1013396423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38750 TRADE CENTER DR STE J",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935513787",
            "telephone_number": "661-267-6400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38750 TRADE CENTER DR STE J",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935513787",
            "telephone_number": "661-267-6400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAGISI DMD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-19",
        "last_updated": "2015-05-19",
        "status": "A",
        "authorized_official_last_name": "SAGISI",
        "authorized_official_first_name": "RANDALL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "661-267-6400",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "63715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PRESTIGE DENTAL CARE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Palmdale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.