Leo Robert Sander, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

5548 Issued in OR

Practice address

1314 NE Grand Ave
Portland, OR 97232-1127

Phone

(503) 280-2877

NPI assigned

Aug 19, 2006

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Kaiser Permanente

  • Dental Hygienist
  • Portland, OR
  • NPI 1922011832
  NPD (past)

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1336253962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10031 SW 71ST PL",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972231147",
            "telephone_number": "503-244-8071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1314 NE GRAND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972321127",
            "telephone_number": "503-280-2877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDER",
        "first_name": "LEO",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "5548",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Scott Alan Sandberg, M.D.
• Janet Frances Sandell, LPC
• Elsa Sandeno
• Barbara A Sander, CADC II
• Laura Baker Sander, LCSW
• Amy Colleen Sanders, LPC
• Benjamin Sanders, MD
• Bernadette Mary Sanders, BSN, RN
• Cody Michelle Sanders
• Collin David Sanders

• General Practice Dentistry in Portland, OR
• Providers in Portland, OR by specialty
• General Practice Dentistry in Oregon

• 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.