Individual provider Active NPI

Danny A Sadakah, DMD

  • Dentist
  • Tualatin, OR
National Provider Identifier
1114093457
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D8684 Issued in OR
Practice address
18773 SW Martinazzi Ave
Tualatin, OR 97062-7458
Phone
(503) 869-4539
NPI assigned
Nov 28, 2006
Sex
Male
Sole proprietor
No

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
Dentist 122300000X D8684 OR Primary

Addresses

Primary practice location

18773 SW Martinazzi Ave
Tualatin, OR 97062-7458

Mailing address

9393 SE Quail Ridge CT
Portland, OR 97266-9175
Phone (503) 869-4539

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
D8684ORMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114093457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9393 SE QUAIL RIDGE CT",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972669175",
            "telephone_number": "503-869-4539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18773 SW MARTINAZZI AVE",
            "city": "TUALATIN",
            "state": "OR",
            "postal_code": "970627458",
            "telephone_number": "503-869-4539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SADAKAH",
        "first_name": "DANNY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OR",
            "license": "D8684",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tualatin, OR

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.