Individual provider Active NPI

Laura Tolusso Garden, D.D.S

  • Dentist
  • Roanoke, VA
National Provider Identifier
1487092300
Registry record updated Nov 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
0401413619 Issued in VA
Practice address
2017 Jefferson St SW
Roanoke, VA 24014-2419
Phone
(540) 981-7128
NPI assigned
Jun 13, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 0401413619 VA Primary

Addresses

Primary practice location

2017 Jefferson St SW
Roanoke, VA 24014-2419

Mailing address

2017 Jefferson St SW
Roanoke, VA 24014-2419
Phone (540) 981-7128

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20191029001787 VA Practitioner - Oral Surgery 2961715529 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Carilion Medical Center CurrentSince Nov 1, 2019 Accepting new patients
Roanoke Endodontics CurrentSince Dec 13, 2022 Accepting new patients
Carilion Medical Center CurrentSince Nov 1, 2019 Accepting new patients

Locations

2017 Jefferson St SW
Roanoke, VA 24014
Phone (540) 981-7128

213 S Jefferson St
Ste 625
Roanoke, VA 24011
Phone (540) 224-5677

1906 Belleview Ave SE
Roanoke, VA 24014
Phone (540) 853-0222

1938 Braeburn Dr
Salem, VA 24153
Phone (540) 989-6648

Organizations & group practices 3

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": "1371081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574294400000",
    "number": "1487092300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2017 JEFFERSON ST SW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240142419",
            "telephone_number": "540-981-7128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2017 JEFFERSON ST SW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240142419",
            "telephone_number": "540-981-7128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDEN",
        "first_name": "LAURA",
        "middle_name": "TOLUSSO",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-13",
        "last_updated": "2019-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401413619",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke, VA

Sources for this page

Verify at the official NPI Registry.