Walter R Sassack, D.D.S. P.C

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12661 Issued in MI

Practice address

17711 Fort St
Riverview, MI 48193-6632

Phone

(734) 283-2818

Fax

(734) 283-2888

NPI assigned

Mar 13, 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

Not listed in the public Medicare enrollment file

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.

• Kristen Miller, D.D.S, P.L.L.C.

  • General Practice Dentistry
  • Riverview, MI
  • NPI 1699432369
  NPD (past)

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407989221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17711 FORT ST",
            "city": "RIVERVIEW",
            "state": "MI",
            "postal_code": "481936632",
            "telephone_number": "734-283-2818",
            "fax_number": "734-283-2888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17711 FORT ST",
            "city": "RIVERVIEW",
            "state": "MI",
            "postal_code": "481936632",
            "telephone_number": "734-283-2818",
            "fax_number": "734-283-2888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SASSACK",
        "first_name": "WALTER",
        "middle_name": "R",
        "credential": "D.D.S. P.C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "12661",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gabrielle Saldana
• Sana Health Inc
• Sana Nasir Inc.
• John A Santoro, DDS
• Sharleen Sarjoo, PT
• Paul R Savickas, PH.D.
• Jeffrey Schultz
• Jolene Marie Scott
• Avtar S Sekhon, MD
• Steven John Serra, D.O.

• General Practice Dentistry in Riverview, MI
• Providers in Riverview, MI by specialty
• General Practice Dentistry in Michigan

• 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.