Active NPI
Sacheen N Garrison, D.D.S.
- General Practice Dentistry
- Groveport, OH
National Provider Identifier
1174603302
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 21392
- Practice address
- 645 Main St
Groveport, OH 43125-1420 - Phone
- (614) 836-0500
- Fax
- (614) 836-6061
- NPI assigned
- Oct 16, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 21392 | OH | Primary |
Addresses
Primary practice location
645 Main St
Groveport, OH 43125-1420
Mailing address
8033 Slate Park Ave
Reynoldsburg, OH 43068-7280
Phone (614) 863-9775
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160809002556 | OH | Order and Referring Only - Other (Physician) | 1759675044 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21392 | OH | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160956800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1174603302",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8033 SLATE PARK AVE",
"city": "REYNOLDSBURG",
"state": "OH",
"postal_code": "430687280",
"telephone_number": "614-863-9775"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "645 MAIN ST",
"city": "GROVEPORT",
"state": "OH",
"postal_code": "431251420",
"telephone_number": "614-836-0500",
"fax_number": "614-836-6061"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GARRISON",
"first_name": "SACHEEN",
"middle_name": "N",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "OH",
"license": "21392",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Groveport, OH
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.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.