Active NPI 1235511858 Individual Practitioner Female Practitioner

Dr. Elise Marie De Latour , DDS

Dentist - General Practice • Augusta, GA

Professional Overview & Biography Verified Profile Summary

Dr. Elise De Latour, DDS is a registered healthcare professional specializing in Dentist - General Practice in Augusta, GA. Practice services are available at 1430 JOHN WESLEY GILBERT DRIVE under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

1430 John Wesley Gilbert Drive

Augusta, GA 309120001

Telephone 7067212371

Fax 7067216778

Associated Practice Facility / Clinic

🏢 Au Dental Associates Facility NPI 1457541781

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Augusta, GA

Active Practitioner

Practitioner Clinical Experience

Active

City Avg: 43.0 Yrs

State Avg: 22.8 Yrs

Regional Practice Density

124 Specialists

Practicing in Augusta, GA (3302 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2023-04-13

Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License GA DNF000450

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Dentist - General Practice

NUCC Taxonomy Code: 1223G0001X

State License FL DN24440

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners

Dr. Geoffrey Thompson , DDS, MS

Dentist - Prosthodontics

NPI 1003807603

Doctor of Dental Surgery, Master of Science

Dr. Steven Nelson , DMD

Dentist - Prosthodontics

NPI 1003861352

Doctor of Dental Medicine

Dr. John Hawkins , CRNA, PhD

Nurse Anesthetist, Certified Registered

NPI 1003880196

Certified Registered Nurse Anesthetist, Doctor of Philosophy (Ph.D.)

Dr. Theodore Ravenel , DMD

Dentist - Endodontics

NPI 1013070879

Doctor of Dental Medicine

Dr. Edna Pashley , DMD

Dentist - Pediatric Dentistry

NPI 1033165584

Doctor of Dental Medicine

Dr. Ryan Mooneyham , DDS

Dentist - Oral and Maxillofacial Surgery

NPI 1033705066

Doctor of Dental Surgery

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

13 Historical Events

📍

Updated Practice Location July 07, 2022

Registered at 1430 JOHN WESLEY GILBERT DRIVE, AUGUSTA, GA 309120001 (Tel: 7067212371)

📍

Updated Business Mailing Address July 07, 2022

Registered at 1430 JOHN WESLEY GILBERT DRIVE, AUGUSTA, GA 309120001 (Tel: 7067212371)

👤

Provider Name / Credentials Updated July 07, 2022

Recorded as ELISE DE LATOUR, DDS

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) July 07, 2022

Dentist (License #DN24440 in FL)

📍

Updated Practice Location April 17, 2018

Registered at 49TH MEDICAL GROUP/SGPD, 280 FIRST STREET, BLDG 23, HOLLOMAN AFB, NM 883308273 (Tel: 5755722259)

📍

Updated Business Mailing Address April 17, 2018

Registered at 49TH MEDICAL GROUP/SGPD, 280 FIRST STREET, BLDG 23, HOLLOMAN AFB, NM 883308273 (Tel: 5755723742)

👤

Provider Name / Credentials Updated April 17, 2018

Recorded as ELISE DE LATOUR, D.D.S.

✅

NPI Profile Active June 19, 2015

NPI status registered as active in NPPES database

📍

Updated Practice Location June 19, 2015

Registered at 340 BOATNER ROAD, EGLIN AFB, FL 32542 (Tel: 8508838324)

📍

Updated Business Mailing Address June 19, 2015

Registered at 340 BOATNER ROAD, EGLIN AFB, FL 32542 (Tel: 8058838324)

👤

Provider Name / Credentials Updated June 19, 2015

Recorded as ELISE HARTMANN, DDS

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) June 19, 2015

Dentist (License #0401414854 in VA)

🟢

Initial NPI Registration & Enumeration June 19, 2015

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1235511858

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: June 19, 2015

Last Update: April 13, 2023

Sole Proprietor: No

Update or Correct Profile

Mailing Address

1430 John Wesley Gilbert Drive

Augusta, GA 309120001

Phone: 7067212371

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.