Individual provider Active NPI

Lucas Sandman, D.D.S.

  • Dentist
  • Fargo, ND
National Provider Identifier
1649560392
Registry record updated Apr 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2106 Issued in ND
Practice address
2217 University Dr N
Fargo, ND 58102-1817
Phone
(701) 237-3517
NPI assigned
Apr 14, 2011
Last updated
Apr 22, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2106 ND Primary

Addresses

Primary practice location

2217 University Dr N
Fargo, ND 58102-1817

Mailing address

3687 Fairway Rd N
Fargo, ND 58102-1278
Phone (701) 290-0196

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

State licenses

LicenseStateTypeSpecialty
2106NDMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Sandman Family Dentistry, LTD Current Accepting new patients

Locations

2217 University Dr N
Fargo, ND 58102
Phone (701) 237-3517

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1302739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555891200000",
    "number": "1649560392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3687 FAIRWAY RD N",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581021278",
            "telephone_number": "701-290-0196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2217 UNIVERSITY DR N",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581021817",
            "telephone_number": "701-237-3517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDMAN",
        "first_name": "LUCAS",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-14",
        "last_updated": "2019-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "ND",
            "license": "2106",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fargo, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 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.