Paul E Ganucheau, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

5403 Issued in LA

Practice address

2636 Athania Pkwy
Metairie, LA 70002-5902

Phone

(504) 218-8444

Fax

(504) 224-2906

NPI assigned

May 22, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540771200000",
    "number": "1215146287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2636 ATHANIA PKWY",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700025902",
            "telephone_number": "504-218-8444",
            "fax_number": "504-224-2906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2636 ATHANIA PKWY",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700025902",
            "telephone_number": "504-218-8444",
            "fax_number": "504-224-2906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANUCHEAU",
        "first_name": "PAUL",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-22",
        "last_updated": "2018-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "LA",
            "license": "5403",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lesa G Gamble
• Katherine Louise Gandert
• Benjamin Gandolfi
• Rashanda Makala Gant
• Byron Charles Ganucheau, D.D.S.
• Brittany Garay, CCC-SLP
• Alexis Garcia
• Jeishlian Garcia
• Peter Garcia IV
• Saul Garcia, PA-C

• General Practice Dentistry in Metairie, LA
• Providers in Metairie, 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 Oct 29, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.