John Sackman, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DE00006301 Issued in WA

Practice address

17900 Talbot Rd. S. #103
Renton, WA 98055

Phone

(425) 271-1727

Fax

(425) 271-1763

NPI assigned

Oct 2, 2006

Last updated

Jul 9, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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)

Not 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Redmond Family Dentistry

  • Dental Clinic/Center
  • Redmond, WA
  • NPI 1497360119
  NPD (past)
• Valley Dental Group

  • General Practice Dentistry
  • Renton, WA
  • NPI 1881788479
  NPD (past)

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1073606521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16260 NE 85TH ST",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980523528",
            "telephone_number": "425-883-6874",
            "fax_number": "425-885-0145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17900 TALBOT RD. S. #103",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "98055",
            "telephone_number": "425-271-1727",
            "fax_number": "425-271-1763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SACKMAN",
        "first_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE00006301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Mae Rydelski, ARNP
• Lesley Elizabeth Rytel
• Kathya Saavedra
• Sandeep Sachdeva, MD
• Jennifer Sachek, PH.D.
• Antoinette Sacomano
• Safeway Inc (Safeway Pharmacy #1563)
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• Hina Sahi, M.D.
• Mayimuna Kamal Said

• General Practice Dentistry in Renton, WA
• Providers in Renton, WA by specialty
• General Practice Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.