Individual provider Active NPI

Sabine Schtakleff, D.D.S.

  • Dentist
  • Carrboro, NC
National Provider Identifier
1164777876
Registry record updated Jul 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
9313 Issued in NC
Practice address
301 Lloyd St
Carrboro, NC 27510-1823
Phone
(919) 942-8741
NPI assigned
Jul 18, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 15, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 0442000155 VA
Dentist 122300000X 9313 NC Primary

Addresses

Primary practice location

301 Lloyd St
Carrboro, NC 27510-1823

Mailing address

301 Lloyd St
Carrboro, NC 27510-1823
Phone (919) 942-8741

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20150731015297 NC Order and Referring Only - DentistPractitioner - Oral SurgeryPractitioner - Dentist 3779897939

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0442000155VAMDDentist
9313NCMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1342569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436918400000",
    "number": "1164777876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 LLOYD ST",
            "city": "CARRBORO",
            "state": "NC",
            "postal_code": "275101823",
            "telephone_number": "919-942-8741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 LLOYD ST",
            "city": "CARRBORO",
            "state": "NC",
            "postal_code": "275101823",
            "telephone_number": "919-942-8741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHTAKLEFF",
        "first_name": "SABINE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-18",
        "last_updated": "2015-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0442000155",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NC",
            "license": "9313",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carrboro, NC

Sources for this page

Verify at the official NPI Registry.