NPIMap

Organization Active NPI

Melancon Family Dentistry LLC

  • Dental Clinic/Center
  • Broussard, LA
National Provider Identifier
1063759736
Registry record updated Jan 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
5974 Issued in LA
Legal business name
MELANCON FAMILY DENTISTRY LLC
Practice address
300 W Madison St
Broussard, LA 70518-4518
Phone
(337) 837-1861
Fax
(337) 837-1278
NPI assigned
Jan 14, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2013

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

Authorized official

Name
Dr. Matthew John Melancon, DDSNPI 1912149980
Title
Owner/Dentist
Phone
(337) 837-1861

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 5974 LA Primary

Addresses

Primary practice location

300 W Madison St
Broussard, LA 70518-4518

Mailing address

300 W Madison St
Broussard, LA 70518-4518
Phone (337) 837-1861

National Provider Directory

National Provider Directory

Locations

300 W Madison St
Broussard, LA 70518
Phone (337) 837-1861

Practitioners & affiliated clinicians

Practitioners 2

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": "1358121600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1358121600000",
    "number": "1063759736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 W MADISON ST",
            "city": "BROUSSARD",
            "state": "LA",
            "postal_code": "705184518",
            "telephone_number": "337-837-1861",
            "fax_number": "337-837-1278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 W MADISON ST",
            "city": "BROUSSARD",
            "state": "LA",
            "postal_code": "705184518",
            "telephone_number": "337-837-1861",
            "fax_number": "337-837-1278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MELANCON FAMILY DENTISTRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-14",
        "last_updated": "2013-01-14",
        "status": "A",
        "authorized_official_last_name": "MELANCON",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "337-837-1861",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "LA",
            "license": "5974",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Broussard, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2013; 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.