Patrick Michael Lonergan, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

4200 Issued in LA

Practice address

3621 Ridgelake Dr Ste 203
Metairie, LA 70002-1739

Phone

(504) 887-1700

Fax

(504) 887-6179

NPI assigned

Nov 14, 2006

Last updated

Dec 11, 2019By the provider in NPPES

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

Other identifiers 1

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

Networks

• LA PPO C-SNP

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576022400000",
    "number": "1033281076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3330 KINGMAN STREET",
            "address_2": "SUITE 5",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "70006",
            "telephone_number": "504-887-1700",
            "fax_number": "504-887-6179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3621 RIDGELAKE DR STE 203",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700021739",
            "telephone_number": "504-887-1700",
            "fax_number": "504-887-6179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONERGAN",
        "first_name": "PATRICK",
        "middle_name": "MICHAEL",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-14",
        "last_updated": "2019-12-11",
        "certification_date": "2019-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "LA",
            "license": "4200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "A2103",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Metairie, LA
• Providers in Metairie, LA by specialty
• Dentist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2019; 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.