Individual provider Active NPI

Spencer N Sautter, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Spokane, WA
National Provider Identifier
1912104654
Registry record updated Jun 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
DE60195746 Issued in WA
Practice address
123 W Francis Ave
Spokane, WA 99205-6348
Phone
(509) 928-8800
Fax
(509) 232-3844
NPI assigned
Jun 27, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X DDS5960 OK
Oral and Maxillofacial Surgery (Dentist) 1223S0112X DE60195746 WA Primary

Addresses

Primary practice location

123 W Francis Ave
Spokane, WA 99205-6348

Mailing address

123 W Francis Ave
Spokane, WA 99205-6348
Phone (509) 928-8800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective May 15, 2015 through May 15, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DDS5960OKMDOral and Maxillofacial Surgery (Dentist)
DE60195746WAMDOral and Maxillofacial Surgery (Dentist)

NPI Registry JSON

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

{
    "created_epoch": "1182902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308528000000",
    "number": "1912104654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 W FRANCIS AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992056348",
            "telephone_number": "509-928-8800",
            "fax_number": "509-232-3844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 W FRANCIS AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992056348",
            "telephone_number": "509-928-8800",
            "fax_number": "509-232-3844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAUTTER",
        "first_name": "SPENCER",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-27",
        "last_updated": "2011-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "OK",
            "license": "DDS5960",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "WA",
            "license": "DE60195746",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

Verify at the official NPI Registry.