Active NPI
Jeffery Allen Hennigan, D.D.S.
- Dentist
- Lake Charles, LA
National Provider Identifier
1114288321
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 6269
- Practice address
- 700 W McNeese St
Lake Charles, LA 70605-5567 - Phone
- (337) 478-8470
- NPI assigned
- Jun 4, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 6269 | LA | Primary |
Addresses
Primary practice location
700 W McNeese St
Lake Charles, LA 70605-5567
Mailing address
815 Touchey St
Lake Charles, LA 70601
Phone (337) 274-7938
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
| License | State | Type | Specialty |
|---|---|---|---|
| 6269 | LA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lake Area Dentistry, LLC | Dentist | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Dentist
- Lake Charles, LA
- NPI 1316316896
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1338768000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1430956800000",
"number": "1114288321",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "815 TOUCHEY ST",
"city": "LAKE CHARLES",
"state": "LA",
"postal_code": "70601",
"telephone_number": "337-274-7938"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "700 W MCNEESE ST",
"city": "LAKE CHARLES",
"state": "LA",
"postal_code": "706055567",
"telephone_number": "337-478-8470"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENNIGAN",
"first_name": "JEFFERY",
"middle_name": "ALLEN",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-06-04",
"last_updated": "2015-05-07",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "LA",
"license": "6269",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake Charles, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.