NPIMap

Organization Active NPI

Boyd DDS LLC

  • Dentist
  • Shreveport, LA
National Provider Identifier
1124568332
Registry record updated Mar 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
6190 Issued in LA
Legal business name
BOYD DDS LLC
Practice address
2042 Line Ave
Shreveport, LA 71104-2125
Phone
(318) 425-5356
Fax
(318) 674-2898
NPI assigned
Mar 7, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2017

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

Authorized official

Name
Dr. McKenzy K Boyd, DDSNPI 1457664906
Title
Owner
Phone
(318) 425-5356

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 6190 LA Primary

Addresses

Primary practice location

2042 Line Ave
Shreveport, LA 71104-2125

Mailing address

2042 Line Ave
Shreveport, LA 71104-2125
Phone (318) 425-5356

Other identifiers 2

IdentifierTypeStateIssuer
1457664906OtherLANPI
1003124397OtherLANPI

National Provider Directory

National Provider Directory

Locations

2042 Line Ave
Shreveport, LA 71104
Phone (318) 425-5356

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1488844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488844800000",
    "number": "1124568332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2042 LINE AVE",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711042125",
            "telephone_number": "318-425-5356",
            "fax_number": "318-674-2898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2042 LINE AVE",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711042125",
            "telephone_number": "318-425-5356",
            "fax_number": "318-674-2898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOYD DDS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-07",
        "last_updated": "2017-03-07",
        "status": "A",
        "authorized_official_last_name": "BOYD",
        "authorized_official_first_name": "MCKENZY",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "318-425-5356",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "LA",
            "license": "6190",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1457664906",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1003124397",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2017; 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.