Charles Edwin Sackett IV, DDS

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

51646 Issued in CA

Practice address

633 E Alvin Drive Ste B
Salinas, CA 93906

Phone

(831) 443-1177

Fax

(831) 443-0705

NPI assigned

Oct 4, 2006

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 identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Central Coast Pediatric Dental Group

  • Pediatric Dentistry
  • Salinas, CA
  • NPI 1205922705
  NPD (past)

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1487740973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "631 E ALVIN DRIVE STUIE C",
            "city": "SALINAS",
            "state": "CA",
            "postal_code": "93906",
            "telephone_number": "831-442-8878",
            "fax_number": "831-443-4611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "633 E ALVIN DRIVE STE B",
            "city": "SALINAS",
            "state": "CA",
            "postal_code": "93906",
            "telephone_number": "831-443-1177",
            "fax_number": "831-443-0705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SACKETT",
        "first_name": "CHARLES",
        "middle_name": "EDWIN",
        "name_prefix": "Dr.",
        "name_suffix": "IV",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "51646",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D51646",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Esmeralda Saavedra, M.S.
• Fabiola Saavedra
• Maira Saavedra, IBCLC
• Brian Sacan, R.N.
• Shawna Nicole Sacan, LMFT, ATR-BC
• Alfred M Sadler, MD
• Alondra Jennifer Saenz-Alvarez, DO
• Javoneh Safakish
• Safeway Inc
• Safeway Inc

• All providers in Salinas, CA
• Pediatric Dentistry in California

• 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.