Provider Demographics
NPI:1538104443
Name:SASSE, KENT C (MD)
Entity Type:Individual
Prefix:DR
First Name:KENT
Middle Name:C
Last Name:SASSE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:75 PRINGLE WAY
Mailing Address - Street 2:SUITE 804
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-1464
Mailing Address - Country:US
Mailing Address - Phone:775-829-7999
Mailing Address - Fax:775-829-7970
Practice Address - Street 1:75 PRINGLE WAY
Practice Address - Street 2:SUITE 804
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-1464
Practice Address - Country:US
Practice Address - Phone:775-829-7999
Practice Address - Fax:775-829-7970
Is Sole Proprietor?:No
Enumeration Date:2006-06-17
Last Update Date:2013-02-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NV9336208600000X, 208C00000X, 2086S0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV2016863Medicaid
NVH26729Medicare UPIN
NV33939Medicare ID - Type Unspecified