Individual provider Active NPI

Kallanthomas Lee Elle, DMD

  • General Practice Dentistry
  • Hammond, LA
National Provider Identifier
1114723186
Registry record updated Apr 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
7767 Issued in LA
Practice address
311 Palace Dr
Hammond, LA 70403-6072
Phone
(985) 791-0076
NPI assigned
Feb 20, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 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 7767 LA Primary

Addresses

Primary practice location

311 Palace Dr
Hammond, LA 70403-6072

Mailing address

311 Palace Dr
Hammond, LA 70403-6072
Phone (985) 791-0076

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
I20250725001778 LA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 7315454378

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7767LAMDGeneral Practice Dentistry

Interoperability endpoints

  • Direct secure messaging: kelle5336458@direct.casso.us.com

NPI Registry JSON

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

{
    "created_epoch": "1740009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776038400000",
    "number": "1114723186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 PALACE DR",
            "city": "HAMMOND",
            "state": "LA",
            "postal_code": "704036072",
            "telephone_number": "985-791-0076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 PALACE DR",
            "city": "HAMMOND",
            "state": "LA",
            "postal_code": "704036072",
            "telephone_number": "985-791-0076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLE",
        "first_name": "KALLANTHOMAS",
        "middle_name": "LEE",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-02-20",
        "last_updated": "2026-04-13",
        "certification_date": "2026-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "LA",
            "license": "7767",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hammond, LA

Sources for this page

Verify at the official NPI Registry.