Healthcare Provider Details

I. General information

NPI: 1538104443
Provider Name (Legal Business Name): KENT C SASSE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2006
Last Update Date: 02/27/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 PRINGLE WAY SUITE 804
RENO NV
89502-1464
US

IV. Provider business mailing address

75 PRINGLE WAY SUITE 804
RENO NV
89502-1464
US

V. Phone/Fax

Practice location:
  • Phone: 775-829-7999
  • Fax: 775-829-7970
Mailing address:
  • Phone: 775-829-7999
  • Fax: 775-829-7970

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number9336
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License Number9336
License Number StateNV
# 3
Primary TaxonomyN
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License Number9336
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: