Organization Active NPI

David C. Raphael, D.D.S.

  • Dentist
  • Metairie, LA
National Provider Identifier
1194065482
Registry record updated Feb 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2077 Issued in LA
Legal business name
DAVID C. RAPHAEL, D.D.S.
Practice address
4432 Conlin St Ste 1a
Metairie, LA 70006-2146
Phone
(504) 888-9204
Fax
(504) 888-4224
NPI assigned
Feb 22, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2013

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

Authorized official

Name
Dr. David Coleman Raphael, D.D.S.
Title
Owner
Phone
(504) 888-9204

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 2077 LA Primary

Addresses

Primary practice location

4432 Conlin St Ste 1a
Metairie, LA 70006-2146

Mailing address

4432 Conlin St Ste 1a
Metairie, LA 70006-2146
Phone (504) 888-9204

Other identifiers 1

IdentifierTypeStateIssuer
1820776MedicaidLA

National Provider Directory

National Provider Directory

Locations

4432 Conlin St
Ste 1A
Metairie, LA 70006
Phone (504) 888-9204

Practitioners & affiliated clinicians

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": "1361491200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1361491200000",
    "number": "1194065482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4432 CONLIN ST STE 1A",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700062146",
            "telephone_number": "504-888-9204",
            "fax_number": "504-888-4224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4432 CONLIN ST STE 1A",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700062146",
            "telephone_number": "504-888-9204",
            "fax_number": "504-888-4224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID C. RAPHAEL, D.D.S.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-22",
        "last_updated": "2013-02-22",
        "status": "A",
        "authorized_official_last_name": "RAPHAEL",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "COLEMAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "504-888-9204",
        "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": "2077",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1820776",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Metairie, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2013; 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.