Provider Demographics
NPI:1174539175
Name:SACHS, SCOTT A (DDS)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:A
Last Name:SACHS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:227 WAGGOMAN DRIVE
Mailing Address - Street 2:
Mailing Address - City:KERRVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78028-6139
Mailing Address - Country:US
Mailing Address - Phone:830-896-1705
Mailing Address - Fax:830-896-6127
Practice Address - Street 1:227 WAGGOMAN DRIVE
Practice Address - Street 2:
Practice Address - City:KERRVILLE
Practice Address - State:TX
Practice Address - Zip Code:78028-6139
Practice Address - Country:US
Practice Address - Phone:830-896-1705
Practice Address - Fax:830-896-6127
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2008-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD144351223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXD14435Medicare UPIN
TXU28140Medicare UPIN