Mark David Lassiter Sr., DDS

Primary specialty

DentistTaxonomy code 122300000X

License

6451 Issued in NC

Practice address

8487 S Scenic Hwy
Bland, VA 24315-4691

Phone

(276) 688-4711

Fax

(276) 688-4712

NPI assigned

Jan 31, 2007

Last updated

Sep 13, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in VA

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Bland County Medical Clinic, Inc.

  • Federally Qualified Health Center (FQHC)
  • Bastian, VA
  • NPI 1104800671
  Medicare reassignment NPD
• Norwood, Lassiter and Associates

  dba Norwood Dental Clinic

  • General Practice Dentistry
  • Norwood, NC
  • NPI 1699948323
  NPD (past) Authorized official
• Bland County Medical Clinic, Inc.

  dba Orchard Creek Clinic

  • Federally Qualified Health Center (FQHC)
  • Bland, VA
  • NPI 1396496063
  NPD
• Londry & Modlin VI DDS PLLC

  dba Norwood Dental Care

  • General Practice Dentistry
  • Norwood, NC
  • NPI 1558904763
  NPD (past)

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726185600000",
    "number": "1265579866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8487 S SCENIC HWY",
            "city": "BLAND",
            "state": "VA",
            "postal_code": "243154691",
            "telephone_number": "276-688-4711",
            "fax_number": "276-688-4712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8487 S SCENIC HWY",
            "city": "BLAND",
            "state": "VA",
            "postal_code": "243154691",
            "telephone_number": "276-688-4711",
            "fax_number": "276-688-4712"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "311 South Main Street",
            "address_purpose": "LOCATION",
            "city": "Norwood",
            "state": "NC",
            "postal_code": "28128",
            "country_code": "US",
            "telephone_number": "704-474-3152",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LASSITER",
        "first_name": "MARK",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "name_suffix": "Sr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-31",
        "last_updated": "2024-09-13",
        "certification_date": "2024-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NC",
            "license": "6451",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8995126",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brandy Derenzis, SLP
• Kayla Briana Dillow, OTR/L
• Madison Elizabeth Dye
• Vincent Filanova, D.D.S.
• Olena Sue Sexton Lambert, DDS
• Katherine Daniels Miller
• Patricia H Mitchell, NP
• Mountain Medical Clinic PC
• Anna Louchheim Pekerol, M.S., CCC-SLP
• Brittany Renae Proffitt, RDH

• Dentist in Bland, VA
• Providers in Bland, VA by specialty
• Dentist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.