Individual provider Active NPI

Michael J Puissegur, D.D.S.

  • General Practice Dentistry
  • Lafayette, LA
National Provider Identifier
1154496628
Registry record updated Jun 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Practice address
201 Rue Louis Xiv
Lafayette, LA 70508-5736
Phone
(337) 984-9400
NPI assigned
Nov 21, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 20, 2022

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 LA Primary

Addresses

Primary practice location

201 Rue Louis Xiv
Lafayette, LA 70508-5736

Mailing address

201 Rue Louis Xiv
Lafayette, LA 70508
Phone (337) 984-9400

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

LicenseStateTypeSpecialty
172800205LAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Puissegur Family Dentistry LLC General Practice CurrentSince Jun 26, 2022 Accepting new patients

Locations

201 Rue Louis Xiv
Lafayette, LA 70508
Phone (337) 984-9400

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.

NPI Registry JSON

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655683200000",
    "number": "1154496628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 RUE LOUIS XIV",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "70508",
            "telephone_number": "337-984-9400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 RUE LOUIS XIV",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705085736",
            "telephone_number": "337-984-9400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUISSEGUR",
        "first_name": "MICHAEL",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-21",
        "last_updated": "2022-06-20",
        "certification_date": "2022-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "LA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2022; 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.