Individual provider Active NPI

Marion Jack Stigall, D.D.S.

  • General Practice Dentistry
  • Alexandria, LA
National Provider Identifier
1093735169
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2333 Issued in LA
Practice address
2495 Shreveport Highway
Alexandria, LA 71306-0000
Phone
(318) 473-0010
Fax
(318) 483-5168
NPI assigned
Jul 20, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

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 2333 LA Primary

Addresses

Primary practice location

2495 Shreveport Highway
Alexandria, LA 71306-0000

Mailing address

2495 Shreveport Highway
Alexandria, LA 71306-0000
Phone (318) 473-0010

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2333LAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1093735169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2495 SHREVEPORT HIGHWAY",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713060000",
            "telephone_number": "318-473-0010",
            "fax_number": "318-483-5168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2495 SHREVEPORT HIGHWAY",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713060000",
            "telephone_number": "318-473-0010",
            "fax_number": "318-483-5168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STIGALL",
        "first_name": "MARION",
        "middle_name": "JACK",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "LA",
            "license": "2333",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, LA

Sources for this page

  • 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.