Akeele Ayanna Johnson-Vallot, DDS, MSD

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

7118 Issued in LA

Practice address

3215 Masonic Dr
Alexandria, LA 71301-4246

Phone

(318) 542-4005

Fax

(318) 542-4006

NPI assigned

Nov 8, 2012

Last updated

Apr 9, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX, LA2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Southern Magnolia Dentistry, LLC

  dba Southern Magnolia Dentistry

  • Pediatric Dentistry
  • Alexandria, LA
  • NPI 1598545386
  Medicare reassignment NPD Authorized official
• Quentin N Burdick Comprehensive Health Care Facility

  • Rural Acute Care Hospital
  • Belcourt, ND
  • NPI 1952346934

  Single Specialty, TX

  Medicare reassignment NPD

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

{
    "created_epoch": "1352332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712620800000",
    "number": "1144574450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3215 MASONIC DR",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713014246",
            "telephone_number": "318-542-4005",
            "fax_number": "318-542-4006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3215 MASONIC DR",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713014246",
            "telephone_number": "318-542-4005",
            "fax_number": "318-542-4006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON-VALLOT",
        "first_name": "AKEELE",
        "middle_name": "AYANNA",
        "credential": "DDS, MSD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-11-08",
        "last_updated": "2024-04-09",
        "certification_date": "2024-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "62022",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "LA",
            "license": "7118",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John C. Sams, M.D. Apmc
• John S. McCabe, M.D., Apc
• Johnson Community Home
• Annie Elizabeth Johnson Salazar, MHS, LPC, NCC
• Demarcquanaee Johnson-Peters, MD
• Amber Michelle Johnson, LPC, MA
• Angela Lucille Johnson, BS
• April M Johnson
• Arthur Johnson Jr., L.A.C.
• Beverly Johnson, R.N., CARN, C.C.M.

• Pediatric Dentistry in Alexandria, LA
• Providers in Alexandria, LA by specialty
• Pediatric Dentistry in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.