Trienel M Sackman, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DE00008061 Issued in WA

Practice address

31775 State Route 20
Suite a-3
Oak Harbor, WA 98277-5139

Phone

(360) 679-9216

Fax

(360) 679-9239

NPI assigned

Nov 21, 2006

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

Other identifiers 3

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.

• Sea Mar Community Health Centers

  • Federally Qualified Health Center (FQHC)
  • Oak Harbor, WA
  • NPI 1598813818
  NPD (past)

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1508931148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 34703",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981241703",
            "telephone_number": "206-764-0112",
            "fax_number": "206-764-0489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31775 STATE ROUTE 20",
            "address_2": "SUITE A-3",
            "city": "OAK HARBOR",
            "state": "WA",
            "postal_code": "982775139",
            "telephone_number": "360-679-9216",
            "fax_number": "360-679-9239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SACKMAN",
        "first_name": "TRIENEL",
        "middle_name": "M",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-21",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE00008061",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5028568",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT LABOR & INDUSTRIES",
            "identifier": "0174962",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD",
            "identifier": "8324SA",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tyler Joseph Rumple, D.D.S.
• Elizabeth Rurey, M.ED
• Joy Ellen Rutherford, M.A., CCC-SLP
• Laura Jean Ryan, L.C.S.W.
• Saar'S Inc
• Safeway Inc
• Jimmy Masami Saiku, DDS
• Alia Samara, MA, LMHC
• Jerald Gail Sanders, M.D.
• Karrie Sanders

• General Practice Dentistry in Oak Harbor, WA
• Providers in Oak Harbor, WA by specialty
• General Practice Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.