Individual provider Active NPI

Joseph G Shedlarski, D,D,S,

  • General Practice Dentistry
  • Gretna, LA
National Provider Identifier
1063542231
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
3593 Issued in LA
Practice address
1808 Franklin Ave
Gretna, LA 70053-3405
Phone
(504) 361-1011
NPI assigned
Mar 6, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 3593 LA Primary

Addresses

Primary practice location

1808 Franklin Ave
Gretna, LA 70053-3405

Mailing address

4409 Laudun St
Metairie, LA 70006-2225
Phone (504) 885-6920

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20160607000340 LA Order and Referring Only - DentistPractitioner - Dentist 0648560490

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063542231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4409 LAUDUN ST",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700062225",
            "telephone_number": "504-885-6920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1808 FRANKLIN AVE",
            "city": "GRETNA",
            "state": "LA",
            "postal_code": "700533405",
            "telephone_number": "504-361-1011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEDLARSKI",
        "first_name": "JOSEPH",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "D,D,S,",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "LA",
            "license": "3593",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gretna, LA

Sources for this page

Verify at the official NPI Registry.