Individual provider Active NPI

Ann-Marie Simon Christen, DDS

  • Dentist
  • Bogalusa, LA
National Provider Identifier
1194399055
Registry record updated Mar 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
7218 Issued in LA
Practice address
600 Shriners Dr
Bogalusa, LA 70427-2684
Phone
(985) 735-0078
NPI assigned
May 16, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 7218 LA Primary

Addresses

Primary practice location

600 Shriners Dr
Bogalusa, LA 70427-2684

Mailing address

84125 Highway 437
Covington, LA 70435-8501
Phone (337) 517-1700

Other practice location 1

600 N Highway 190 Ste 4
Covington, LA 70433-5083
Phone (337) 517-1700

Other practice location 2

1301 Eastridge Dr
Slidell, LA 70458-3026
Phone (985) 643-8800

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
I20210603000814 LA Order and Referring Only - DentistPractitioner - Dentist 8123427671

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1621123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647993600000",
    "number": "1194399055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "84125 HIGHWAY 437",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704358501",
            "telephone_number": "337-517-1700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 SHRINERS DR",
            "city": "BOGALUSA",
            "state": "LA",
            "postal_code": "704272684",
            "telephone_number": "985-735-0078"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 N Highway 190 Ste 4",
            "address_purpose": "LOCATION",
            "city": "Covington",
            "state": "LA",
            "postal_code": "704335083",
            "country_code": "US",
            "telephone_number": "337-517-1700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1301 Eastridge Dr",
            "address_purpose": "LOCATION",
            "city": "Slidell",
            "state": "LA",
            "postal_code": "704583026",
            "country_code": "US",
            "telephone_number": "985-643-8800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHRISTEN",
        "first_name": "ANN-MARIE",
        "middle_name": "SIMON",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-16",
        "last_updated": "2022-03-23",
        "certification_date": "2022-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "LA",
            "license": "7218",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bogalusa, LA

Sources for this page

Verify at the official NPI Registry.