Individual provider Active NPI

Kenneth E. Morgan, DDS,LLC

  • Dentist
  • Lafayette, LA
National Provider Identifier
1013199793
Registry record updated Dec 4, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
5492 Issued in LA
Practice address
102 Genevieve Dr
Lafayette, LA 70503-4811
Phone
(337) 981-6882
Fax
(337) 991-0542
NPI assigned
Dec 4, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 5492 LA Primary

Addresses

Primary practice location

102 Genevieve Dr
Lafayette, LA 70503-4811

Mailing address

102 Genevieve Dr
Lafayette, LA 70503-4811
Phone (337) 981-6882

Other identifiers 1

IdentifierTypeStateIssuer
1854921MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
5492LAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Saloom Family Dentistry, LLC PastSince Feb 25, 2024 Accepting new patients
Dale M Trahan DDS LLC Dentist Past Accepting new patients

Networks

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

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1196726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196726400000",
    "number": "1013199793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 GENEVIEVE DR",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705034811",
            "telephone_number": "337-981-6882",
            "fax_number": "337-991-0542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 GENEVIEVE DR",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705034811",
            "telephone_number": "337-981-6882",
            "fax_number": "337-991-0542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORGAN",
        "first_name": "KENNETH",
        "middle_name": "E.",
        "credential": "DDS,LLC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-12-04",
        "last_updated": "2007-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "LA",
            "license": "5492",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1854921",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.