Individual provider Active NPI

Randy Jay Sachs, DMD

  • General Practice Dentistry
  • Lake Worth, FL
National Provider Identifier
1417080490
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN 15737 Issued in FL
Practice address
9835 Lake Worth Rd Ste 8
Lake Worth, FL 33467-2368
Phone
(561) 434-3055
Fax
(561) 434-7037
NPI assigned
Mar 13, 2007
Sex
Male
Sole proprietor
Yes

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 DN 15737 FL Primary

Addresses

Primary practice location

9835 Lake Worth Rd Ste 8
Lake Worth, FL 33467-2368

Mailing address

8829 Sandy Crest LN
Boynton Beach, FL 33437-7813
Phone (561) 434-3055

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20160425001702 FL Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 0840599908

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN 15737FLMDGeneral Practice Dentistry

Networks

  • Freedom Health HMO Network

NPI Registry JSON

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": "1417080490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8829 SANDY CREST LN",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334377813",
            "telephone_number": "561-434-3055",
            "fax_number": "561-434-7037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9835 LAKE WORTH RD STE 8",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334672368",
            "telephone_number": "561-434-3055",
            "fax_number": "561-434-7037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SACHS",
        "first_name": "RANDY",
        "middle_name": "JAY",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN 15737",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Worth, FL

Sources for this page

Verify at the official NPI Registry.