Mark Randal Comeaux, DDS

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

3129 Issued in LA

Practice address

3839 West Congress Street
Suite D
Lafayette, LA 70506-6021

Phone

(337) 989-0267

Fax

(337) 989-9030

NPI assigned

Mar 21, 2007

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

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

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Periodontics Associates, LLP

  • Periodontics
  • Lafayette, LA
  • NPI 1932263506
  NPD (past) Authorized official

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1083739486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3839 WEST CONGRESS STREET",
            "address_2": "SUITE D",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705066021",
            "telephone_number": "337-989-0267",
            "fax_number": "337-989-9030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3839 WEST CONGRESS STREET",
            "address_2": "SUITE D",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705066021",
            "telephone_number": "337-989-0267",
            "fax_number": "337-989-9030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COMEAUX",
        "first_name": "MARK",
        "middle_name": "RANDAL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "LA",
            "license": "3129",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Candace Jeanine Comeaux
• Donna F Comeaux, CRNA
• Jason R Comeaux, PA-C
• Jerrick Comeaux, M.A., BCBA, LBA
• Marie Comeaux
• Megan King Comeaux, O.T.
• Michelle Marie Comeaux
• Nicole Comeaux, MS CCC-SLP
• Roy Thomas Comeaux Jr., R.N.
• Shunda Comeaux

• Periodontics in Lafayette, LA
• Providers in Lafayette, LA by specialty
• Periodontics 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.