Provider Demographics
NPI:1679023089
Name:CARL M. SAKAMAKI, D.D.S.,P.C.
Entity Type:Organization
Organization Name:CARL M. SAKAMAKI, D.D.S.,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CARL
Authorized Official - Middle Name:
Authorized Official - Last Name:SAKAMAKI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:303-477-4075
Mailing Address - Street 1:2480 W. 26TH AVE.
Mailing Address - Street 2:STE. 320-B
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80211-5322
Mailing Address - Country:US
Mailing Address - Phone:303-477-4075
Mailing Address - Fax:303-477-6778
Practice Address - Street 1:2480 W. 26TH AVE.
Practice Address - Street 2:STE. 320-B
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80211-5322
Practice Address - Country:US
Practice Address - Phone:303-477-4075
Practice Address - Fax:303-477-6778
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-10
Last Update Date:2016-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO8487122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO82454272Medicaid