Individual provider Active NPI

Colten Ducote, DDS, MD

  • Oral and Maxillofacial Surgery (Dentist)
  • Shreveport, LA
National Provider Identifier
1093122202
Registry record updated Jul 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
6495 Issued in LA
Practice address
7600 Fern Ave Ste 600
Shreveport, LA 71105-5688
Phone
(318) 797-5812
NPI assigned
Jul 20, 2014
Last updated
Jul 18, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 6495 LA Primary

Addresses

Primary practice location

7600 Fern Ave Ste 600
Shreveport, LA 71105-5688

Mailing address

7600 Fern Ave Ste 600
Shreveport, LA 71105-5688
Phone (318) 797-5812

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200720001425 LA Practitioner - Maxillofacial SurgeryPractitioner - Oral Surgery 4486874278 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Maxillofacial SurgeryAlso: Oral Surgery
Education
Texas a & M University System, HSC, College of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1050 Bancorp S Cir
Suite 400
Bossier City, LA 71111-2217
Phone (318) 747-5812

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
6495LAMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Arklatex Oral & Maxillofacial Surgery a Partnership of Professional de Oral and Maxillofacial Surgery CurrentSince Jul 1, 2020 Accepting new patients

Locations

1050 Bancorp South Cir
Ste 400
Bossier City, LA 71111
Phone (318) 747-5812

7600 Fern Ave
Ste 1400
Shreveport, LA 71105
Phone (318) 797-5812

7600 Fern Ave
Ste 600
Shreveport, LA 71105
Phone (318) 797-5812

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1405814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689638400000",
    "number": "1093122202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7600 FERN AVE STE 600",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711055688",
            "telephone_number": "318-797-5812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7600 FERN AVE STE 600",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711055688",
            "telephone_number": "318-797-5812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUCOTE",
        "first_name": "COLTEN",
        "name_prefix": "Dr.",
        "credential": "DDS, MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-07-20",
        "last_updated": "2023-07-18",
        "certification_date": "2023-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "LA",
            "license": "6495",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

Verify at the official NPI Registry.