Individual provider Active NPI

Latasha N. Sauls, D.D.S.

  • Dentist
  • Charlottesville, VA
National Provider Identifier
1952632879
Registry record updated Aug 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
0401413286 Issued in VA
Practice address
1222 Jefferson Park Ave FL 2N
Charlottesville, VA 22903-3410
Phone
(434) 924-1774
Fax
(434) 243-6378
NPI assigned
Jan 15, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Dentist 122300000X 0401413286 VA Primary

Addresses

Primary practice location

1222 Jefferson Park Ave FL 2N
Charlottesville, VA 22903-3410

Mailing address

PO Box 9007
Charlottesville, VA 22906-9007

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
I20151002001674 VA Practitioner - DentistPractitioner - Oral Surgery 2062720584 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
University of Virginia Physicians Group CurrentSince Aug 7, 2015 Accepting new patients
Madison Family Dentistry, PLLC Past Accepting new patients

Locations

1222 Jefferson Park Ave
Fl 2
Charlottesville, VA 22903
Phone (434) 924-1774

1222 Jefferson Park Ave
Fl 2N
Charlottesville, VA 22903
Phone (434) 924-1774

1215 Lee St
Fl 8
Charlottesvle, VA 22908
Phone (434) 924-2500

Organizations & group practices 2

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": "1263513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439337600000",
    "number": "1952632879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9007",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229069007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1222 JEFFERSON PARK AVE FL 2N",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229033410",
            "telephone_number": "434-924-1774",
            "fax_number": "434-243-6378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAULS",
        "first_name": "LATASHA",
        "middle_name": "N.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-15",
        "last_updated": "2015-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401413286",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlottesville, VA

Sources for this page

Verify at the official NPI Registry.