NPIMap

Organization Active NPI

Michael a Sacro DDS PC

Doing business as Ferndale Family Dental

  • Dentist
  • Ferndale, WA
National Provider Identifier
1629498407
Registry record updated Apr 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
60453211 Issued in WA
Legal business name
MICHAEL A SACRO DDS PC
Doing business as
Ferndale Family Dental
Practice address
6004 Portal Way Unit a
Ferndale, WA 98248-8382
Phone
(360) 384-3440
Fax
(360) 384-6028
NPI assigned
Apr 21, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2014

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

Authorized official

Name
Michael A Sacro, DDSNPI 1235410333
Title
President/Dentist
Phone
(360) 384-3440

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
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 60453211 WA Primary

Addresses

Primary practice location

6004 Portal Way Unit a
Ferndale, WA 98248-8382

Mailing address

6004 Portal Way Unit a
Ferndale, WA 98248-8382
Phone (360) 384-3440

Other names 1

  • Ferndale Family Dental Doing business as

National Provider Directory

National Provider Directory

Locations

6004 Portal Way
Unit A
Ferndale, WA 98248
Phone (360) 384-3440

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1398038400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1398038400000",
    "number": "1629498407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6004 PORTAL WAY UNIT A",
            "city": "FERNDALE",
            "state": "WA",
            "postal_code": "982488382",
            "telephone_number": "360-384-3440",
            "fax_number": "360-384-6028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6004 PORTAL WAY UNIT A",
            "city": "FERNDALE",
            "state": "WA",
            "postal_code": "982488382",
            "telephone_number": "360-384-3440",
            "fax_number": "360-384-6028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL A SACRO DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-21",
        "last_updated": "2014-04-21",
        "status": "A",
        "authorized_official_last_name": "SACRO",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT/DENTIST",
        "authorized_official_telephone_number": "360-384-3440",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "WA",
            "license": "60453211",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ferndale Family Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ferndale, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2014; 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.