Individual provider Active NPI

Charles A. Sarlo Jr., D.D.S., P.A.

  • Oral and Maxillofacial Surgery (Dentist)
  • Palm Bay, FL
National Provider Identifier
1285792986
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
9520 Issued in FL
Practice address
5201 Babcock St NE Ste 8
Palm Bay, FL 32905-4637
Phone
(321) 984-2565
Fax
(321) 984-2926
NPI assigned
Dec 5, 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
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 9520 FL Primary

Addresses

Primary practice location

5201 Babcock St NE Ste 8
Palm Bay, FL 32905-4637

Mailing address

5201 Babcock St NE Ste 8
Palm Bay, FL 32905-4637
Phone (321) 984-2565

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
9520FLMDOral and Maxillofacial Surgery (Dentist)
OS9520FLMDHospitalist Physician

NPI Registry JSON

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1285792986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5201 BABCOCK ST NE STE 8",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329054637",
            "telephone_number": "321-984-2565",
            "fax_number": "321-984-2926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5201 BABCOCK ST NE STE 8",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329054637",
            "telephone_number": "321-984-2565",
            "fax_number": "321-984-2926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SARLO",
        "first_name": "CHARLES",
        "middle_name": "A.",
        "name_suffix": "Jr.",
        "credential": "D.D.S., P.A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "FL",
            "license": "9520",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Bay, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.