Marisol Sastoque-Tiller, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

10141 Issued in NC

Practice address

11030 Golf Links Dr Ste 201
Charlotte, NC 28277-8047

Phone

(704) 321-0414

NPI assigned

Jun 19, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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 and National Provider Directory roles.

• Erron S Brady DMD PA

  • Durable Medical Equipment & Medical Supplies
  • Charlotte, NC
  • NPI 1144996711
  NPD
• Erron S Brady DMD PA

  • Durable Medical Equipment & Medical Supplies
  • Charlotte, NC
  • NPI 1639346877

  General Practice

  NPD (past)

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

{
    "created_epoch": "1403136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663286400000",
    "number": "1306250154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11030 GOLF LINKS DR STE 201",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282778047",
            "telephone_number": "704-321-0414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11030 GOLF LINKS DR STE 201",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282778047",
            "telephone_number": "704-321-0414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SASTOQUE-TILLER",
        "first_name": "MARISOL",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-19",
        "last_updated": "2022-09-16",
        "certification_date": "2022-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "10141",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Sassy Stylez
• Avni Kiritkumar Satasia, PA
• Madhankumar Sathyamoorthy, M.D.
• Ritvij Satodiya, MD
• James Albert Satterfield
• Jamison Jerome Satterfield, M.D.

• General Practice Dentistry in Charlotte, NC
• Providers in Charlotte, NC by specialty
• General Practice Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2022; 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.