Provider Demographics
NPI:1659868818
Name:SATIN, KARLIE (DDS)
Entity Type:Individual
Prefix:
First Name:KARLIE
Middle Name:
Last Name:SATIN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:KARLIE
Other - Middle Name:
Other - Last Name:KASHAT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:2749 GREEN ST
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32205-7428
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:653 W 8TH ST
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32209-6511
Practice Address - Country:US
Practice Address - Phone:904-244-2000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-13
Last Update Date:2022-02-25
Deactivation Date:2018-06-29
Deactivation Code:
Reactivation Date:2018-07-25
Provider Licenses
StateLicense IDTaxonomies
FLDN24754122300000X
FLDRPM20091223S0112X, 390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program