Active NPI
Sandra Jean Lo, DDS
- Dentist
- Sacramento, CA
National Provider Identifier
1639366115
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 30142
- Practice address
- 3835 Freeport Blvd
RS 134
Sacramento, CA 95822-1318 - Phone
- (916) 558-2650
- Fax
- (916) 558-2067
- NPI assigned
- Sep 28, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 30142 | CA | Primary |
Addresses
Primary practice location
3835 Freeport Blvd
RS 134
Sacramento, CA 95822-1318
Mailing address
3835 Freeport Blvd
RS 134
Sacramento, CA 95822-1318
Phone (916) 558-2650
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1190937600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1190937600000",
"number": "1639366115",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3835 FREEPORT BLVD",
"address_2": "RS 134",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958221318",
"telephone_number": "916-558-2650",
"fax_number": "916-558-2067"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3835 FREEPORT BLVD",
"address_2": "RS 134",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958221318",
"telephone_number": "916-558-2650",
"fax_number": "916-558-2067"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LO",
"first_name": "SANDRA",
"middle_name": "JEAN",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-09-28",
"last_updated": "2007-09-28",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "30142",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sacramento, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 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.