Individual provider Active NPI

John J Sauk, DDS

  • Oral and Maxillofacial Pathology Dentistry
  • Louisville, KY
National Provider Identifier
1497838262
Registry record updated Feb 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Pathology DentistryTaxonomy code 1223P0106X
License
8565 Issued in KY
Practice address
501 S Preston St
Louisville, KY 40202-1701
Phone
(502) 852-1304
Fax
(502) 852-3364
NPI assigned
Oct 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Pathology Dentistry 1223P0106X 2901009195 MD
Oral and Maxillofacial Pathology Dentistry 1223P0106X 8565 KY Primary

Addresses

Primary practice location

501 S Preston St
Louisville, KY 40202-1701

Mailing address

501 S Preston St
Louisville, KY 40202-1701
Phone (502) 852-1304

Other identifiers 2

IdentifierTypeStateIssuer
418538200MedicaidMD
190003329OtherMDRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20150204000955 KY Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 3678897071

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8565KYMDOral and Maxillofacial Pathology Dentist
2901009195MDMDOral and Maxillofacial Pathology Dentist

NPI Registry JSON

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297987200000",
    "number": "1497838262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 S PRESTON ST",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021701",
            "telephone_number": "502-852-1304",
            "fax_number": "502-852-3364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 S PRESTON ST",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021701",
            "telephone_number": "502-852-1304",
            "fax_number": "502-852-3364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAUK",
        "first_name": "JOHN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-23",
        "last_updated": "2011-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0106X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "MD",
            "license": "2901009195",
            "primary": false
        },
        {
            "code": "1223P0106X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "KY",
            "license": "8565",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "418538200",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "190003329",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.