Individual provider Active NPI

William Joseph Carlisle III, DDS

  • General Practice Dentistry
  • Marrero, LA
National Provider Identifier
1174583041
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
3530 Issued in LA
Practice address
2665 Barataria Blvd
Marrero, LA 70072-5609
Phone
(504) 348-4232
Fax
(504) 348-8094
NPI assigned
Mar 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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 3530 LA Primary

Addresses

Primary practice location

2665 Barataria Blvd
Marrero, LA 70072-5609

Mailing address

2665 Barataria Blvd
Marrero, LA 70072-5609
Phone (504) 348-4232

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
I20160208000956 LA Order and Referring Only - DentistPractitioner - Dentist 2062716384

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3530LAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Fabre Family Dental Care of Marrero General Practice Past Accepting new patients
Fabre Family Dental Care of Metairie, L.L.C General Practice Past Accepting new patients

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": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1174583041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2665 BARATARIA BLVD",
            "city": "MARRERO",
            "state": "LA",
            "postal_code": "700725609",
            "telephone_number": "504-348-4232",
            "fax_number": "504-348-8094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2665 BARATARIA BLVD",
            "city": "MARRERO",
            "state": "LA",
            "postal_code": "700725609",
            "telephone_number": "504-348-4232",
            "fax_number": "504-348-8094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLISLE",
        "first_name": "WILLIAM",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-24",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "LA",
            "license": "3530",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marrero, LA

Sources for this page

Verify at the official NPI Registry.