Active NPI
Frank J. Distefano, D.D.S.
- Dentist
- Morgan City, LA
National Provider Identifier
1033258967
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- LA 2051
- Practice address
- 1016 David Dr
Morgan City, LA 70380-1318 - Phone
- (985) 384-6907
- Fax
- (985) 384-6953
- NPI assigned
- Feb 6, 2007
- Last updated
- Jul 8, 2007
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | LA 2051 | LA | Primary |
Addresses
Primary practice location
1016 David Dr
Morgan City, LA 70380-1318
Mailing address
PO Box 2425
907 Second St.
Morgan City, LA 70381-2425
Phone (985) 384-4751
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 |
|---|---|---|---|
| LA 2051 | LA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170720000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1033258967",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2425",
"address_2": "907 SECOND ST.",
"city": "MORGAN CITY",
"state": "LA",
"postal_code": "703812425",
"telephone_number": "985-384-4751"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1016 DAVID DR",
"city": "MORGAN CITY",
"state": "LA",
"postal_code": "703801318",
"telephone_number": "985-384-6907",
"fax_number": "985-384-6953"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DISTEFANO",
"first_name": "FRANK",
"middle_name": "J.",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-06",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "LA",
"license": "LA 2051",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Morgan City, LA
- Linsey Daigle, FNP
- Department of Health and Hospitals (St Mary Treatment Center)
- Department of Health and Hospitals (St. Mary Assessment Center)
- Brooke V Derouen, MA, LAC, LPC
- Natalie Jude Dishman, M.D.
- Angela Fuller Doiron, NP
- Chad Jeremy Domangue, NURSE PRACTITIONER
- Whybra Joseph Duay Jr., D.D.S.
- Sara Dugas
- Ladelle Rene Dunlap, DC
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.