Provider Demographics
NPI:1417080490
Name:SACHS, RANDY JAY (DMD)
Entity Type:Individual
Prefix:DR
First Name:RANDY
Middle Name:JAY
Last Name:SACHS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8829 SANDY CREST LN
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33437-7813
Mailing Address - Country:US
Mailing Address - Phone:561-434-3055
Mailing Address - Fax:561-434-7037
Practice Address - Street 1:9835 LAKE WORTH RD STE 8
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33467-2368
Practice Address - Country:US
Practice Address - Phone:561-434-3055
Practice Address - Fax:561-434-7037
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 157371223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice