NPIMap

Organization Active NPI

Douglas M George DDS LLC

  • Dental Clinic/Center
  • Ponchatoula, LA
National Provider Identifier
1154901668
Registry record updated Jun 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
DOUGLAS M GEORGE DDS LLC
Practice address
430 E Pine St
Ponchatoula, LA 70454-2544
Phone
(318) 348-4795
NPI assigned
Apr 9, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2021

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

Authorized official

Name
Douglas George, DDSNPI 1750879854
Title
Owner
Phone
(318) 348-4795

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
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

430 E Pine St
Ponchatoula, LA 70454-2544

Mailing address

430 E Pine St
Ponchatoula, LA 70454-2544
Phone (985) 386-8454

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Ponchatoula Direct

National Provider Directory

National Provider Directory

Practitioners 1

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": "1617926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623110400000",
    "number": "1154901668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 E PINE ST",
            "city": "PONCHATOULA",
            "state": "LA",
            "postal_code": "704542544",
            "telephone_number": "985-386-8454",
            "fax_number": "985-386-8467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 E PINE ST",
            "city": "PONCHATOULA",
            "state": "LA",
            "postal_code": "704542544",
            "telephone_number": "318-348-4795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOUGLAS M GEORGE DDS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-09",
        "last_updated": "2021-06-08",
        "certification_date": "2021-04-12",
        "status": "A",
        "authorized_official_last_name": "GEORGE",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "318-348-4795",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Ponchatoula",
            "affiliation": "N",
            "endpointDescription": "Work",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "430 E Pine St",
            "city": "Ponchatoula",
            "state": "LA",
            "country_code": "US",
            "postal_code": "704542544",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Ponchatoula, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2021; 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.