MEDICARE: DR. MADISON WALLACE SAUNDERS DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223E0200X	Endodontics	0401415721	VA
2	1223G0001X	General Practice Dentistry	0401415721	VA

General Provider Information

NPI Number	:	1629588066
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MADISON WALLACE SAUNDERS DDS

Provider Business Mailing Address
First Line	:	2701 HYDRAULIC RD SUITE 103
Second Line	:
City	:	CHARLOTTESVILLE
State	:	VA
Zip	:	22901-9059
Country	:	US
Telephone Number	:	434-973-4301
Fax Number	:

Provider Business Practice Location Address
First Line	:	2701 HYDRAULIC ROAD
Second Line	:	SUITE 103
City	:	CHARLOTTESVILLE
State	:	VA
Zip	:	22901-9059
Country	:	US
Telephone Number	:	434-973-4301
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/11/2017
Last Update Date	:	03/12/2026

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