NPIMap

Organization Active NPI

Robert B. Lestage, DDS, LLC

  • Dentist
  • Deridder, LA
National Provider Identifier
1174843692
Registry record updated Jun 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
6041 Issued in LA
Legal business name
ROBERT B. LESTAGE, DDS, LLC
Practice address
509 Bon Ami St
Deridder, LA 70634-4925
Phone
(337) 463-3272
NPI assigned
Jun 7, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2010

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

Authorized official

Name
Dr. Robert B Lestage, D.D.S.NPI 1033421581
Title
Dentist
Phone
(337) 463-3272

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
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 6041 LA Primary

Addresses

Primary practice location

509 Bon Ami St
Deridder, LA 70634-4925

Mailing address

509 Bon Ami St
Deridder, LA 70634-4925
Phone (337) 463-3272

National Provider Directory

National Provider Directory

Locations

509 Bon Ami St
Deridder, LA 70634
Phone (337) 463-3272

Practitioners & affiliated clinicians

Practitioners 2

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": "1275868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1275868800000",
    "number": "1174843692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "509 BON AMI ST",
            "city": "DERIDDER",
            "state": "LA",
            "postal_code": "706344925",
            "telephone_number": "337-463-3272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 BON AMI ST",
            "city": "DERIDDER",
            "state": "LA",
            "postal_code": "706344925",
            "telephone_number": "337-463-3272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT B. LESTAGE, DDS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-07",
        "last_updated": "2010-06-07",
        "status": "A",
        "authorized_official_last_name": "LESTAGE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "337-463-3272",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "LA",
            "license": "6041",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Deridder, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2010; 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.