Individual provider Active NPI

Marc Sandler, DDS

  • General Practice Dentistry
  • Philadelphia, PA
National Provider Identifier
1053477604
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DS020274-L Issued in PA
Practice address
7675 Bustleton Ave
Philadelphia, PA 19152-4109
Phone
(215) 338-3336
Fax
(215) 338-7340
NPI assigned
Dec 28, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 DS020274-L PA Primary

Addresses

Primary practice location

7675 Bustleton Ave
Philadelphia, PA 19152-4109

Mailing address

PO Box 667
Narberth, PA 19072-0667
Phone (215) 338-3336

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
DS020274-LPAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053477604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 667",
            "city": "NARBERTH",
            "state": "PA",
            "postal_code": "190720667",
            "telephone_number": "215-338-3336",
            "fax_number": "215-338-7340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7675 BUSTLETON AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191524109",
            "telephone_number": "215-338-3336",
            "fax_number": "215-338-7340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDLER",
        "first_name": "MARC",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS020274-L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.