Individual provider Active NPI

Patrick Bryan Sandlin, D.D.S.

  • General Practice Dentistry
  • Roseville, CA
National Provider Identifier
1033210208
Registry record updated Aug 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
23557 Issued in CA
Practice address
720 Sunrise Ave
Suite 120a
Roseville, CA 95661-4516
Phone
(916) 783-0471
Fax
(916) 783-0484
NPI assigned
Sep 26, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 25, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 23557 CA Primary

Addresses

Primary practice location

720 Sunrise Ave
Suite 120a
Roseville, CA 95661-4516

Mailing address

720 Sunrise Ave Ste 120a
Roseville, CA 95661-4540
Phone (916) 783-0471

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
23557CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282694400000",
    "number": "1033210208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 SUNRISE AVE STE 120A",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956614540",
            "telephone_number": "916-783-0471",
            "fax_number": "916-783-0484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 SUNRISE AVE",
            "address_2": "SUITE 120A",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956614516",
            "telephone_number": "916-783-0471",
            "fax_number": "916-783-0484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDLIN",
        "first_name": "PATRICK",
        "middle_name": "BRYAN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-26",
        "last_updated": "2010-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "23557",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2010; 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.