Healthcare Provider Details

I. General information

NPI: 1669995593
Provider Name (Legal Business Name): SCARLET BEATRIZ CHARMELO SILVA DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/23/2017
Last Update Date: 04/22/2025
Certification Date: 04/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1430 JOHN WESLEY GILBERT DR
AUGUSTA GA
30912-0001
US

IV. Provider business mailing address

1430 JOHN WESLEY GILBERT DRIVE GC-1012
AUGUSTA GA
30912-0001
US

V. Phone/Fax

Practice location:
  • Phone: 706-721-0406
  • Fax: 706-721-4937
Mailing address:
  • Phone: 706-721-0406
  • Fax: 706-721-4937

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code125Q00000X
TaxonomyOral Medicine Dentistry
License NumberDNF000428
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License NumberDNF000428
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: