NPIMap

Individual provider Active NPI

Joshua Cole Reaves, D.D.S.

  • Endodontics
  • Lafayette, LA
National Provider Identifier
1023405990
Registry record updated Mar 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
6470 Issued in LA
Practice address
4906 Ambassador Caffery Pkwy
Suite 1501 Building O
Lafayette, LA 70508-6962
Phone
(337) 981-0144
Fax
(337) 981-0162
NPI assigned
Apr 18, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 23, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 6470 LA
Endodontics 1223E0200X 6470 LA Primary

Addresses

Primary practice location

4906 Ambassador Caffery Pkwy
Suite 1501 Building O
Lafayette, LA 70508-6962

Mailing address

4906 Ambassador Caffery Pkwy
Suite 1501 Building O
Lafayette, LA 70508-6962
Phone (337) 981-0144

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
6470LAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1429315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679529600000",
    "number": "1023405990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4906 AMBASSADOR CAFFERY PKWY",
            "address_2": "SUITE 1501 BUILDING O",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705086962",
            "telephone_number": "337-981-0144",
            "fax_number": "337-981-0162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4906 AMBASSADOR CAFFERY PKWY",
            "address_2": "SUITE 1501 BUILDING O",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705086962",
            "telephone_number": "337-981-0144",
            "fax_number": "337-981-0162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REAVES",
        "first_name": "JOSHUA",
        "middle_name": "COLE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-04-18",
        "last_updated": "2023-03-23",
        "certification_date": "2023-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "LA",
            "license": "6470",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "LA",
            "license": "6470",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Mar 23, 2023; 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.