Active NPI
Fred Osamu Sakamoto, DDS
- Periodontics
- Blacklick, OH
National Provider Identifier
1437246154
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 30016951
- Practice address
- 7334 E Broad St
Blacklick, OH 43004-9239 - Phone
- (614) 575-0070
- Fax
- (614) 575-0068
- NPI assigned
- Oct 6, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 30016951 | OH | Primary |
Addresses
Primary practice location
7334 E Broad St
Blacklick, OH 43004-9239
Mailing address
3060 Lewis Center Rd
Lewis Center, OH 43035-9207
Phone (740) 548-4622
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30016951 | OH | MD | Periodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160092800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1437246154",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3060 LEWIS CENTER RD",
"city": "LEWIS CENTER",
"state": "OH",
"postal_code": "430359207",
"telephone_number": "740-548-4622",
"fax_number": "740-548-2338"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7334 E BROAD ST",
"city": "BLACKLICK",
"state": "OH",
"postal_code": "430049239",
"telephone_number": "614-575-0070",
"fax_number": "614-575-0068"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAKAMOTO",
"first_name": "FRED",
"middle_name": "OSAMU",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-06",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "OH",
"license": "30016951",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Blacklick, OH
Sources for this page
- 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.