Active NPI
Sandra Fogel
- Dentist
- Yakima, WA
National Provider Identifier
1932518628
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DE60880906
- Practice address
- 1120 S 18TH St
Yakima, WA 98901-3654 - Phone
- (509) 573-5530
- Fax
- (509) 654-7012
- NPI assigned
- Aug 6, 2014
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Public Health Dentistry | 1223D0001X | D13066 | MN | |
| Dentist | 122300000X | DE60880906 | WA | Primary |
Addresses
Primary practice location
1120 S 18TH St
Yakima, WA 98901-3654
Mailing address
1120 S 18TH St
Yakima, WA 98901-3654
Phone (509) 573-5530
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | sfogel27280@yvfwc.direct-ci.com | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AK
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160121002474 | AK | Order and Referring Only - Dentist | 0446553655 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DE60880906 | WA | MD | Dentist |
| D13066 | MN | MD | Public Health Dentist |
Interoperability endpoints
- sfogel27280@yvfwc.direct-ci.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1407283200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1615939200000",
"number": "1932518628",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1120 S 18TH ST",
"city": "YAKIMA",
"state": "WA",
"postal_code": "989013654",
"telephone_number": "509-573-5530",
"fax_number": "509-654-7012"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1120 S 18TH ST",
"city": "YAKIMA",
"state": "WA",
"postal_code": "989013654",
"telephone_number": "509-573-5530",
"fax_number": "509-654-7012"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FOGEL",
"first_name": "SANDRA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-08-06",
"last_updated": "2021-03-17",
"certification_date": "2021-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "1223D0001X",
"taxonomy_group": "",
"desc": "Dentist, Dental Public Health",
"state": "MN",
"license": "D13066",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "WA",
"license": "DE60880906",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "sfogel27280@yvfwc.direct-ci.com",
"affiliation": "N",
"endpointDescription": "YVFWC Direct Email Address",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CCDA",
"address_1": "1120 S 18th St",
"city": "Yakima",
"state": "WA",
"country_code": "US",
"postal_code": "989013654",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Yakima, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.