Individual provider Active NPI

Patricia Ann Salter, DMD

  • General Practice Dentistry
  • Lagrange, GA
National Provider Identifier
1376609784
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
10421 Issued in GA
Practice address
1423 Lafayette Pkwy
Lagrange, GA 30241-2552
Phone
(706) 884-2457
Fax
(706) 845-9786
NPI assigned
Dec 29, 2006
Sex
Female
Sole proprietor
No

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
General Practice Dentistry 1223G0001X 10421 GA Primary

Addresses

Primary practice location

1423 Lafayette Pkwy
Lagrange, GA 30241-2552

Mailing address

1423 Lafayette Pkwy
Lagrange, GA 30241-2552
Phone (706) 884-2457

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
I20150729009038 GA Order and Referring Only - DentistPractitioner - Dentist 7012221427

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10421GAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Patricia Ann Deloach Salter, DMD, PC General Practice PastSince Jun 30, 1988 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1167350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376609784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1423 LAFAYETTE PKWY",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302412552",
            "telephone_number": "706-884-2457",
            "fax_number": "706-845-9786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1423 LAFAYETTE PKWY",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302412552",
            "telephone_number": "706-884-2457",
            "fax_number": "706-845-9786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALTER",
        "first_name": "PATRICIA",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "10421",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lagrange, GA

Sources for this page

Verify at the official NPI Registry.