Reginald Sherod Saddoris, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

D4770 Issued in OR

Practice address

857 Fairway View Dr
Eugene, OR 97401-7604

Phone

(541) 344-7684

NPI assigned

Apr 24, 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

Other names 1

• Reginald Sherod Borton Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407075047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "857 FAIRWAY VIEW DR",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974017604",
            "telephone_number": "541-344-7684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "857 FAIRWAY VIEW DR",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974017604",
            "telephone_number": "541-344-7684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SADDORIS",
        "first_name": "REGINALD",
        "middle_name": "SHEROD",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OR",
            "license": "D4770",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REGINALD",
            "last_name": "BORTON",
            "middle_name": "SHEROD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Dentist in Eugene, OR
• Providers in Eugene, OR by specialty
• Dentist 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.