NPIMap

Organization Active NPI

Lake Area Dentistry-Carlyss

  • Dental Clinic/Center
  • Sulphur, LA
National Provider Identifier
1043706252
Registry record updated Jul 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
LA-6269 Issued in LA
Legal business name
LAKE AREA DENTISTRY-CARLYSS
Practice address
4985 Highway 27 S
Sulphur, LA 70665-7571
Phone
(337) 583-2756
NPI assigned
Jul 11, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2018

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

Authorized official

Name
Dr. Jeffery Hennigan, DDS
Title
Owner
Phone
(337) 478-8470

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X LA-6269 LA Primary

Addresses

Primary practice location

4985 Highway 27 S
Sulphur, LA 70665-7571

Mailing address

4985 Highway 27 S
Sulphur, LA 70665-7571
Phone (337) 583-2756

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1531267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531267200000",
    "number": "1043706252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4985 HIGHWAY 27 S",
            "city": "SULPHUR",
            "state": "LA",
            "postal_code": "706657571",
            "telephone_number": "337-583-2756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4985 HIGHWAY 27 S",
            "city": "SULPHUR",
            "state": "LA",
            "postal_code": "706657571",
            "telephone_number": "337-583-2756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE AREA DENTISTRY-CARLYSS",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-11",
        "last_updated": "2018-07-11",
        "status": "A",
        "authorized_official_last_name": "HENNIGAN",
        "authorized_official_first_name": "JEFFERY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "337-478-8470",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "LA",
            "license": "LA-6269",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sulphur, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2018; 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.