Individual provider Active NPI

Douglas David Sandquist, DDS

  • General Practice Dentistry
  • Las Vegas, NV
National Provider Identifier
1366564361
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
3219 Issued in NV
Practice address
2650 Lake Sahara Dr Ste 160
Suite 160
Las Vegas, NV 89117-3451
Phone
(702) 734-0776
Fax
(702) 734-7761
NPI assigned
Apr 3, 2007
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
General Practice Dentistry 1223G0001X 3219 NV Primary

Addresses

Primary practice location

2650 Lake Sahara Dr Ste 160
Suite 160
Las Vegas, NV 89117-3451

Mailing address

2650 Lake Sahara Dr Ste 160
Suite 160
Las Vegas, NV 89117-3451
Phone (702) 734-0776

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150421001008 NV Order and Referring Only - Other (Non-Physician) 0648598763

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3219NVMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
David B Sandquist DDS LTD General Practice Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366564361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2650 LAKE SAHARA DR STE 160",
            "address_2": "SUITE 160",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891173451",
            "telephone_number": "702-734-0776",
            "fax_number": "702-734-7761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2650 LAKE SAHARA DR STE 160",
            "address_2": "SUITE 160",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891173451",
            "telephone_number": "702-734-0776",
            "fax_number": "702-734-7761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDQUIST",
        "first_name": "DOUGLAS",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NV",
            "license": "3219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.