Individual provider Active NPI

Savannah Grace Sagle, DDS

  • Dentist
  • Cincinnati, OH
National Provider Identifier
1093554222
Registry record updated May 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
30.027528 Issued in OH
Practice address
3802 Paxton Ave Ste 12a
Cincinnati, OH 45209-2399
Phone
(513) 898-1194
NPI assigned
May 20, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 30.027528 OH Primary

Addresses

Primary practice location

3802 Paxton Ave Ste 12a
Cincinnati, OH 45209-2399

Mailing address

5540 Shockton CT
Mason, OH 45040-4683
Phone (513) 505-9959

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250804003218 OH Order and Referring Only - DentistPractitioner - Dentist 6406364116

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Dentists at Hyde Park Plaza, PC, Inc Dentist PastSince May 26, 2024 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1716163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716163200000",
    "number": "1093554222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5540 SHOCKTON CT",
            "city": "MASON",
            "state": "OH",
            "postal_code": "450404683",
            "telephone_number": "513-505-9959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3802 PAXTON AVE STE 12A",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452092399",
            "telephone_number": "513-898-1194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAGLE",
        "first_name": "SAVANNAH",
        "middle_name": "GRACE",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-05-20",
        "last_updated": "2024-05-20",
        "certification_date": "2024-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30.027528",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.