Provider Demographics
NPI:1760873822
Name:SACKSTEDER, JAMES M (DDS, MS)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:M
Last Name:SACKSTEDER
Suffix:
Gender:M
Credentials:DDS, MS
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Mailing Address - Street 1:252 E 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43201-3663
Mailing Address - Country:US
Mailing Address - Phone:614-584-4059
Mailing Address - Fax:
Practice Address - Street 1:4805 PARK ROAD
Practice Address - Street 2:SUITE 220
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28209
Practice Address - Country:US
Practice Address - Phone:704-900-5043
Practice Address - Fax:980-224-7956
Is Sole Proprietor?:No
Enumeration Date:2015-02-11
Last Update Date:2021-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.0249631223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics