John R Saunderson, DMD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

035166 Issued in CA

Practice address

2801 Waterman Blvd
240
Fairfield, CA 94534-2987

Phone

(707) 428-5427

Fax

(707) 428-1922

NPI assigned

Jan 29, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Tyler E Nelson DMD MD Inc

  • Oral and Maxillofacial Surgery Clinic/Center
  • Fairfield, CA
  • NPI 1174913578
  NPD (past)

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063558054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 WATERMAN BLVD",
            "address_2": "240",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "94534",
            "telephone_number": "707-421-9466",
            "fax_number": "707-421-8126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 WATERMAN BLVD",
            "address_2": "240",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945342987",
            "telephone_number": "707-428-5427",
            "fax_number": "707-428-1922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAUNDERSON",
        "first_name": "JOHN",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "035166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ali Sarhaddi, PHARM.D
• Stella Marie Sarmiento, D.O.
• Joahnna Sarno, MD
• Alexis Olayinka Sasere
• Mandi Sauer
• Jennifer Nichole Savage
• Tiffany S Savage, PSYD
• Myah Patrice Nicole Savoy
• Melanie Sayas
• Florinda Sayson, RN

• Oral and Maxillofacial Surgery (Dentist) in Fairfield, CA
• Providers in Fairfield, CA by specialty
• Oral and Maxillofacial Surgery (Dentist) in California

• 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.