Joseph Rustom, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6500 Issued in LA

Practice address

425 W Lafayette St
Winnfield, LA 71483-3463

Phone

(318) 302-3261

Fax

(318) 302-3266

NPI assigned

Jun 25, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Winn Community Health Center, Inc.

  dba Winn Community Dental Center

  • Federally Qualified Health Center (FQHC)
  • Winnfield, LA
  • NPI 1295175750

  Dentist

  NPD (past)
• Winn Community Health Center, Inc.

  dba Cypress Springs ESBC

  • Federally Qualified Health Center (FQHC)
  • Ruston, LA
  • NPI 1447133459
  NPD (past)

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

{
    "created_epoch": "1403654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682294400000",
    "number": "1205241510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1288",
            "city": "WINNFIELD",
            "state": "LA",
            "postal_code": "714831288",
            "telephone_number": "318-648-0375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 W LAFAYETTE ST",
            "city": "WINNFIELD",
            "state": "LA",
            "postal_code": "714833463",
            "telephone_number": "318-302-3261",
            "fax_number": "318-302-3266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSTOM",
        "first_name": "JOSEPH",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-25",
        "last_updated": "2023-04-24",
        "certification_date": "2023-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "LA",
            "license": "6500",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "LA",
            "license": "6500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rapides Health Care System, LLC (Winn Parish Medical Center-Hospital Based Physicians)
• Kathleen B Richardson, FNP
• Terri Lynn Roberts, FNP-C
• Chasity Ross, PHARMACISTS
• Robin Roussell, FNP-C
• Saline Emergency Group, LLC
• Michael James Santos, PT
• SCF Medical Services LLC
• Shalom Clinic for Children RHC Inc
• Mark Vance Shelton, M.D.

• General Practice Dentistry in Winnfield, LA
• Providers in Winnfield, LA by specialty
• General Practice Dentistry in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2023; 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.