Dale Roberts Sackett, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

703 Issued in WY

Practice address

312 N 8TH St W
Riverton, WY 82501-3315

Phone

(307) 856-2778

NPI assigned

Jan 22, 2007

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

Enrolled in TX

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

Specialty

Dentist

Education

Univ of Nebraska Medical Center, Col of Dentistry, 1977

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

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 and National Provider Directory roles.

• Eastern Shoshone Tribe

  • Federal Public Health Clinic/Center
  • Fort Washakie, WY
  • NPI 1770328718

  TX

  Medicare reassignment NPD
• Colton J Crane DMD PC

  dba Rendezvous Dental

  • Dental Clinic/Center
  • Riverton, WY
  • NPI 1477849289
  NPD (past)

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1215081690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "312 N 8TH ST W",
            "city": "RIVERTON",
            "state": "WY",
            "postal_code": "825013315",
            "telephone_number": "307-856-2778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "312 N 8TH ST W",
            "city": "RIVERTON",
            "state": "WY",
            "postal_code": "825013315",
            "telephone_number": "307-856-2778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SACKETT",
        "first_name": "DALE",
        "middle_name": "ROBERTS",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WY",
            "license": "703",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kianna Rodriguez
• Julie Reba Rogers, CPS
• Tracy Dawn Romberg, CHILD FORENSIC INTER
• Gretta M Roth, M. COUN., L.P.C
• Kari Sack, CRNA
• William Nolan Sage, L.A.T.
• Jolene Samuelson, MS, CCC-SLP
• Lori Sanders
• Arlene Santillanes
• Virginia Marie Sargent

• General Practice Dentistry in Riverton, WY
• Providers in Riverton, WY by specialty
• General Practice Dentistry in Wyoming

• 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.