Omer S Sanabria, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

7258 Issued in OK

Practice address

325TH MDG
340 Magnolia Circle, BLDG. 1465
Tyndall Afb, FL 32403-5604

Phone

(850) 283-7838

NPI assigned

Sep 11, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1505088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724371200000",
    "number": "1669991758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325TH MDG",
            "address_2": "340 MAGNOLIA CIRCLE, BLDG. 1465",
            "city": "TYNDALL AFB",
            "state": "FL",
            "postal_code": "324035604",
            "telephone_number": "850-283-7838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325TH MDG",
            "address_2": "340 MAGNOLIA CIRCLE, BLDG. 1465",
            "city": "TYNDALL AFB",
            "state": "FL",
            "postal_code": "324035604",
            "telephone_number": "850-283-7838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANABRIA",
        "first_name": "OMER",
        "middle_name": "S",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-11",
        "last_updated": "2024-08-23",
        "certification_date": "2024-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30.024746",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OK",
            "license": "7258",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Lynn Pippin, M.D.
• Clairissa Richardson, DSW, LCSW
• Lakisha G Roe, PHARMD
• Mary Grace Rojas, PHARMD
• Rachel J Runswick, LCSW
• Bobby Sarivannara, O.D.
• Jennifer Olivia Simmons, D.D.S.
• James Edward Smith, MSW, LCSW, QS
• Melissa Brooks Smith, LCSW
• Michael R Staklinski, DPT

• General Practice Dentistry in Tyndall Afb, FL
• Providers in Tyndall Afb, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2024; 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.