NPIMap

Organization Active NPI

Sackheim Dental PLLC

  • General Practice Dentistry
  • Pensacola, FL
National Provider Identifier
1609278068
Registry record updated Jul 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN18697 Issued in FL
Legal business name
SACKHEIM DENTAL PLLC
Practice address
4627 N Davis Hwy
Building B
Pensacola, FL 32503-2364
Phone
(850) 476-2602
Fax
(850) 476-1638
NPI assigned
Sep 17, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2019

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

Authorized official

Name
Dr. William Eric Sackheim, DMDNPI 1982834925
Title
Owner Dentist
Phone
(850) 476-2602

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X DN18697 FL Primary

Addresses

Primary practice location

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

Mailing address

4627 N Davis Hwy
Building B
Pensacola, FL 32503-2364
Phone (850) 476-2602

Other names 1

  • Pelican Dental, PLLC Former legal business name

National Provider Directory

National Provider Directory

Locations

4627 N Davis Hwy
Ste B
Pensacola, FL 32503
Phone (850) 476-2602

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1410912000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1563926400000",
    "number": "1609278068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4627 N DAVIS HWY",
            "address_2": "BUILDING B",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325032364",
            "telephone_number": "850-476-2602",
            "fax_number": "850-476-1638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4627 N DAVIS HWY",
            "address_2": "BUILDING B",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325032364",
            "telephone_number": "850-476-2602",
            "fax_number": "850-476-1638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SACKHEIM DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-17",
        "last_updated": "2019-07-24",
        "status": "A",
        "authorized_official_last_name": "SACKHEIM",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "ERIC",
        "authorized_official_title_or_position": "OWNER DENTIST",
        "authorized_official_telephone_number": "850-476-2602",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN18697",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pelican Dental, PLLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Pensacola, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2019; 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.