Sergio P. Saucedo, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

56687 Issued in CA

Practice address

6165 Valley Springs Pkwy.
Ste. E
Riverside, CA 92507

Phone

(951) 214-6585

Fax

(951) 214-6589

NPI assigned

Dec 21, 2007

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

Medicare fee-for-service enrollment

Enrolled in CA

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

Practice roles

Locations

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.

• Sergio P. Saucedo DDS Inc.

  • Dental Clinic/Center
  • Riverside, CA
  • NPI 1124324561
  NPD Authorized official

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

{
    "created_epoch": "1198195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224201600000",
    "number": "1578747820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6165 VALLEY SPRINGS PKWY.",
            "address_2": "STE. E",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "92507",
            "telephone_number": "951-214-6585",
            "fax_number": "951-214-6589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6165 VALLEY SPRINGS PKWY.",
            "address_2": "STE. E",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "92507",
            "telephone_number": "951-214-6585",
            "fax_number": "951-214-6589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAUCEDO",
        "first_name": "SERGIO",
        "middle_name": "P.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-12-21",
        "last_updated": "2008-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "56687",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Elizabeth Satenstein
• Satori Medical Supply, Inc.
• Isabel Siana Sauceda
• Aileen Saucedo
• Ashley Saucedo
• Krystal Faye Saum, NP
• Angelena Nicole Saunders
• Denise Lynn Saunders, FNP
• Katrina Saunders
• Kimberly Jo Savage, FNP-C

• Dentist in Riverside, CA
• Providers in Riverside, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2008; 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.