Glen Randal Sachau, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

M-512 Issued in SD

Practice address

1440 N 10TH St
Spearfish, SD 57783-1532

Phone

(605) 642-5767

Fax

(605) 642-5769

NPI assigned

May 23, 2006

Last updated

Apr 11, 2018By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. G. Randy Sachau Professional name

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• William Blauer DDS PLLC

  • General Practice Dentistry
  • Spearfish, SD
  • NPI 1396454179
  NPD (past)

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523404800000",
    "number": "1518912914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1440 N 10TH ST",
            "city": "SPEARFISH",
            "state": "SD",
            "postal_code": "577831532",
            "telephone_number": "605-642-5767",
            "fax_number": "605-642-5769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1440 N 10TH ST",
            "city": "SPEARFISH",
            "state": "SD",
            "postal_code": "577831532",
            "telephone_number": "605-642-5767",
            "fax_number": "605-642-5769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SACHAU",
        "first_name": "GLEN",
        "middle_name": "RANDAL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-23",
        "last_updated": "2018-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SD",
            "license": "M-512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "G.",
            "last_name": "SACHAU",
            "middle_name": "RANDY",
            "prefix": "DR.",
            "credential": "DDS",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• General Practice Dentistry in Spearfish, SD
• Providers in Spearfish, SD by specialty
• General Practice Dentistry in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2018; 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.