Individual provider Active NPI

Lawrence M Saltzman, DDS

  • Dentist
  • Duluth, GA
National Provider Identifier
1053484220
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
9885 Issued in GA
Practice address
3800 Satellite Blvd
Gwinnett Place Commons
Duluth, GA 30096-5058
Phone
(770) 495-0824
Fax
(770) 813-9848
NPI assigned
Nov 16, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 9885 GA Primary

Addresses

Primary practice location

3800 Satellite Blvd
Gwinnett Place Commons
Duluth, GA 30096-5058

Mailing address

3800 Satellite Blvd
Gwinnett Place Commons
Duluth, GA 30096-5058
Phone (770) 495-0824

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150715001382 GA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 1658684931

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9885GAMDDentist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053484220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3800 SATELLITE BLVD",
            "address_2": "GWINNETT PLACE COMMONS",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300965058",
            "telephone_number": "770-495-0824",
            "fax_number": "770-813-9848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 SATELLITE BLVD",
            "address_2": "GWINNETT PLACE COMMONS",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300965058",
            "telephone_number": "770-495-0824",
            "fax_number": "770-813-9848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALTZMAN",
        "first_name": "LAWRENCE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GA",
            "license": "9885",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, GA

Sources for this page

Verify at the official NPI Registry.