Sandra Maria Iacob, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

D8175 Issued in OR

Practice address

11808 SE Sunnyside Rd
Clackamas, OR 97015-9308

Phone

(503) 698-1112

Fax

(503) 698-1119

NPI assigned

May 15, 2008

Last updated

May 15, 2008By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Dental Doc PC

  dba Happy Valley Dental Care

  • Dentist
  • Clackamas, OR
  • NPI 1285618470
  Authorized official Same address or phone

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

{
    "created_epoch": "1210809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210809600000",
    "number": "1669649901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11808 SE SUNNYSIDE RD",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970159308",
            "telephone_number": "503-698-1112",
            "fax_number": "503-698-1119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11808 SE SUNNYSIDE RD",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970159308",
            "telephone_number": "503-698-1112",
            "fax_number": "503-698-1119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IACOB",
        "first_name": "SANDRA",
        "middle_name": "MARIA",
        "name_prefix": "Ms.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-15",
        "last_updated": "2008-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OR",
            "license": "D8175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeremy Huttner
• Craig Hutto, ACNP
• Quyen J Huynh, EFDA
• Daniel Wei-Te Hwang, PHARM.D.
• Stephanie Lynn Hwang, OD
• John Anthony Iatesta, D.C.
• Michelle Ichikawa, MD
• Joy M Imholt
• Indepencare LLC (Oasis Housing)
• Valerie Rose Ing, DO

• Dentist in Clackamas, OR
• Providers in Clackamas, OR by specialty
• Dentist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2008; 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.