Kenneth W Parks, DDS

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

3873 Issued in LA

Practice address

636 West McNeese St
Lake Charles, LA 70605

Phone

(337) 477-6124

Fax

(337) 477-6885

NPI assigned

Aug 21, 2006

Last updated

Jul 8, 2007By 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 3

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

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1043326390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "636 WEST MCNEESE ST",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "70605",
            "telephone_number": "337-477-6124",
            "fax_number": "337-477-6885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "636 WEST MCNEESE ST",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "70605",
            "telephone_number": "337-477-6124",
            "fax_number": "337-477-6885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKS",
        "first_name": "KENNETH",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "LA",
            "license": "3873",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF LA",
            "identifier": "G1204",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "807933",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1838730",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica Pardo, SLP
• George Lock Paret III, RPH
• Donald R. Parker, M.D.
• Kaitlyn Parker, BCBA, LBA
• Karl Sylvester Parker
• Michaelynn Joyce Parks, LCSW
• Roberta Arnold Parks
• Natalie Alese Parsley
• Amanda Partin, RN
• Partners in Physical Therapy

• Endodontics in Lake Charles, LA
• Providers in Lake Charles, LA by specialty
• Endodontics in Louisiana

• 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.
• 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.