Individual provider Active NPI

Shawn David Murphy Jr., DDS

  • Dentist
  • Ruston, LA
National Provider Identifier
1164047304
Registry record updated Jun 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
7073 Issued in LA
Practice address
306 E Reynolds Dr Ste 1
Ruston, LA 71270-2847
Phone
(318) 255-6780
NPI assigned
Jun 13, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 7073 LA Primary

Addresses

Primary practice location

306 E Reynolds Dr Ste 1
Ruston, LA 71270-2847

Mailing address

306 E Reynolds Dr Ste 1
Ruston, LA 71270-2847
Phone (318) 255-6780

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
I20240418002891 LA Practitioner - Dentist 0244690816 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dentist
Education
Louisiana State University School of Dentistry, 2020
Medicare assignment
May accept Medicare assignment
Group practices
Johnston and Murphy Dental Care LLCGroup PAC ID 0143683847, 2 clinicians

Practice addresses (Care Compare)

306 E Reynolds Dr
Ruston, LA 71270-2846
Phone (318) 255-6780

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7073LAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Johnston and Murphy Dental Care LLC Dentist CurrentSince Apr 26, 2022 Accepting new patients
Johnston Dental Care Dentist PastSince Jun 21, 2020 Accepting new patients

Locations

306 E Reynolds Dr
Ste 1
Ruston, LA 71270
Phone (318) 255-6780

306 E Reynolds Dr
Ruston, LA 71270
Phone (318) 255-6780

Organizations & group practices 2

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": "1592006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687305600000",
    "number": "1164047304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "306 E REYNOLDS DR STE 1",
            "city": "RUSTON",
            "state": "LA",
            "postal_code": "712702847",
            "telephone_number": "318-255-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 E REYNOLDS DR STE 1",
            "city": "RUSTON",
            "state": "LA",
            "postal_code": "712702847",
            "telephone_number": "318-255-6780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MURPHY",
        "first_name": "SHAWN",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-13",
        "last_updated": "2023-06-21",
        "certification_date": "2023-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "LA",
            "license": "7073",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ruston, LA

Sources for this page

Verify at the official NPI Registry.