Lara Carlson Sackheim, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

DN18679 Issued in FL

Practice address

4627 N Davis Hwy
BLDG B
Pensacola, FL 32503-2364

Phone

(850) 476-2602

NPI assigned

Jul 31, 2009

Sex

Female

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

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

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.

• Sackheim Dental PLLC

  • General Practice Dentistry
  • Pensacola, FL
  • NPI 1609278068
  NPD (past)

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

{
    "created_epoch": "1248998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429574400000",
    "number": "1508097023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6031 CHAPMAN CIR",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325047950",
            "telephone_number": "850-377-9764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4627 N DAVIS HWY",
            "address_2": "BLDG B",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325032364",
            "telephone_number": "850-476-2602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SACKHEIM",
        "first_name": "LARA",
        "middle_name": "CARLSON",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-31",
        "last_updated": "2015-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN18679",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sean Michael Ryan, PHYSICIAN ASSISTANT
• Thiruppathy R. Sabapathy, D.O.
• Melissa T Sabat, CRNA
• Dania Sabooni, MD
• Sackheim Dental PLLC
• Robert Morris Sackheim, MD
• William Eric Sackheim, DMD
• Alan I. Sacks, MD
• Sacred Heart ASC, LLC
• Sacred Heart Health System

• Dentist in Pensacola, FL
• Providers in Pensacola, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.