Mark M. Meredith, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

3006 Issued in LA

Practice address

2914 Betin Avenue
Monroe, LA 71201-7495

Phone

(318) 388-1250

Fax

(318) 388-0948

NPI assigned

Jan 26, 2007

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Networks

• MS PPO D-SNP
• MS PPO C-SNP
• LA PPO C-SNP
• TX HMO D-SNP

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Primary Health Services Center

  • Federally Qualified Health Center (FQHC)
  • Monroe, LA
  • NPI 1053604892
  NPD (past)
• Primary Health Services Center

  • Federally Qualified Health Center (FQHC)
  • Monroe, LA
  • NPI 1316291495
  NPD (past)
• Primary Health Services Center

  • Federally Qualified Health Center (FQHC)
  • Monroe, LA
  • NPI 1629173869
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430265600000",
    "number": "1013063866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2914 BETIN AVENUE",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712017495",
            "telephone_number": "318-388-1250",
            "fax_number": "318-388-0948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2914 BETIN AVENUE",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712017495",
            "telephone_number": "318-388-1250",
            "fax_number": "318-388-0948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEREDITH",
        "first_name": "MARK",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-26",
        "last_updated": "2015-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "LA",
            "license": "3006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Monroe, LA
• Providers in Monroe, LA by specialty
• General Practice Dentistry in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.