Robert J Sanders, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

M611 Issued in SD

Practice address

221 6TH Ave SE
Aberdeen, SD 57401-4362

Phone

(605) 226-1867

Fax

(605) 226-3993

NPI assigned

Aug 30, 2006

Last updated

Jul 9, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in SD

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.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1952411241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 6TH AVE SE",
            "city": "ABERDEEN",
            "state": "SD",
            "postal_code": "574014362",
            "telephone_number": "605-226-1867",
            "fax_number": "605-226-3993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 6TH AVE SE",
            "city": "ABERDEEN",
            "state": "SD",
            "postal_code": "574014362",
            "telephone_number": "605-226-1867",
            "fax_number": "605-226-3993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDERS",
        "first_name": "ROBERT",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SD",
            "license": "M611",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCND PROVIDER #",
            "identifier": "24748",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41337",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL SERV CORP",
            "identifier": "991971",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Russell Kimball LLC (Aberdeen Massage)
• Bethany Lynn Russell, O,D.
• Stan R Ryman, DC
• Carla Ada Salzer
• Whitney S Sample
• Amy L Sanderson, LCSW-PIP
• Sanford Aberdeen Medical Center
• Sanford Health Network (Sanford Aberdeen Orthopedics)
• Sanford Health Network (Sanford Aberdeen Medical Center)
• Sanford Health Network

• General Practice Dentistry in Aberdeen, SD
• Providers in Aberdeen, SD by specialty
• General Practice Dentistry in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.

Verify at the official NPI Registry.