Individual provider Active NPI

Lewis King Scott, D.D.S.

  • General Practice Dentistry
  • West Monroe, LA
National Provider Identifier
1104820778
Registry record updated Jul 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
3200 Issued in LA
Practice address
120 Professional Dr
West Monroe, LA 71291-5332
Phone
(318) 322-1500
Fax
(318) 322-9714
NPI assigned
Jun 10, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2026

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 3200 LA Primary

Addresses

Primary practice location

120 Professional Dr
West Monroe, LA 71291-5332

Mailing address

120 Professional Dr
West Monroe, LA 71291-5332
Phone (318) 322-1500

Other identifiers 2

IdentifierTypeStateIssuer
LA LICENSE --3200OtherLALA LICENSE NUMBER
1632006MedicaidLA

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
I20230904000229 LA Practitioner - Dentist 1153633227 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Primary Health Services Center Current Accepting new patients
Primary Health Services Center CurrentSince Nov 4, 2024 Accepting new patients
Vivian Dental CurrentSince Aug 14, 2023 Accepting new patients
L. King Scott DDS, LTD. General Practice Past Accepting new patients

Locations

2913 Desiard St
Monroe, LA 71201
Phone (318) 651-9914

815 S Pine St
Vivian, LA 71082
Phone (318) 375-3239

Networks

  • LA PPO C-SNP

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1118361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785283200000",
    "number": "1104820778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 PROFESSIONAL DR",
            "city": "WEST MONROE",
            "state": "LA",
            "postal_code": "712915332",
            "telephone_number": "318-322-1500",
            "fax_number": "318-322-9714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 PROFESSIONAL DR",
            "city": "WEST MONROE",
            "state": "LA",
            "postal_code": "712915332",
            "telephone_number": "318-322-1500",
            "fax_number": "318-322-9714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCOTT",
        "first_name": "LEWIS",
        "middle_name": "KING",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-10",
        "last_updated": "2026-07-29",
        "certification_date": "2026-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "LA",
            "license": "3200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LA LICENSE NUMBER",
            "identifier": "LA LICENSE --3200",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1632006",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Monroe, LA

Sources for this page

Verify at the official NPI Registry.