Healthcare Provider Details

I. General information

NPI: 1962838151
Provider Name (Legal Business Name): SAULO LEONARDO SOUSA MELO D.D.S., M.S., PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/19/2013
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 NEWTON RD
IOWA CITY IA
52242-1001
US

IV. Provider business mailing address

322 DENTAL SCIENCE BLDG S
IOWA CITY IA
52242-1001
US

V. Phone/Fax

Practice location:
  • Phone: 319-335-7440
  • Fax: 319-335-7451
Mailing address:
  • Phone: 319-335-7440
  • Fax: 319-335-7451

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0008X
TaxonomyOral and Maxillofacial Radiology Dentistry
License NumberFAC-40159
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code1223X0008X
TaxonomyOral and Maxillofacial Radiology Dentistry
License NumberDF0046
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: