Kevin Sanders, D.D.S.
Dentist, General Practice in Glendale, WI. Individual provider (NPI-1).
NPI number1457745754
StatusActive
Last updated in NPPESApr 3, 2018
Details
- NPI
- 1457745754
- Entity type
- Individual (NPI-1)
- Name
- Kevin Sanders
- Credential
- D.D.S.
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Mar 24, 2015
- Last updated
- Apr 3, 2018
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | 60561209 | WA | Yes |
Practice location
6115 N Green Bay AveGlendale, WI 53209-3813
Phone 509-302-9715
Mailing address
720 N Argonne RdSpokane Valley, WA 99212-2794
Phone 509-928-7500 · Fax 509-928-0904
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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