Active NPI
Jason R. Ray, DDS
- General Practice Dentistry
- Thibodaux, LA
National Provider Identifier
1023040789
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 4305
- Practice address
- 698 E 1St St
Thibodaux, LA 70301-3546 - Phone
- (985) 446-8037
- Fax
- (985) 447-4648
- NPI assigned
- Jul 6, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 4305 | LA | Primary |
Addresses
Primary practice location
698 E 1St St
Thibodaux, LA 70301-3546
Mailing address
698 E 1St St
Thibodaux, LA 70301-3546
Phone (985) 446-8037
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| A2078 | Other | LA | BLUE CROSS BLUE SHIELD |
| 847061 | Other | LA | US GOV UNITED CONCORDIA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 4305 | LA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152144000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1023040789",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "698 E 1ST ST",
"city": "THIBODAUX",
"state": "LA",
"postal_code": "703013546",
"telephone_number": "985-446-8037",
"fax_number": "985-447-4648"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "698 E 1ST ST",
"city": "THIBODAUX",
"state": "LA",
"postal_code": "703013546",
"telephone_number": "985-446-8037",
"fax_number": "985-447-4648"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAY",
"first_name": "JASON",
"middle_name": "R.",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-06",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "LA",
"license": "4305",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "A2078",
"state": "LA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "US GOV UNITED CONCORDIA",
"identifier": "847061",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Thibodaux, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.