David Bulot, DDS, MD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

5625 Issued in LA

Practice address

411 Moncla Ave
Belle Chasse, LA 70037-2314

Phone

(504) 208-1287

NPI assigned

May 3, 2008

Last updated

May 3, 2008By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Sep 14, 2013 through Sep 14, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1209772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209772800000",
    "number": "1225204837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 MONCLA AVE",
            "city": "BELLE CHASSE",
            "state": "LA",
            "postal_code": "700372314",
            "telephone_number": "504-208-1287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 MONCLA AVE",
            "city": "BELLE CHASSE",
            "state": "LA",
            "postal_code": "700372314",
            "telephone_number": "504-208-1287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULOT",
        "first_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "DDS, MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-05-03",
        "last_updated": "2008-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "LA",
            "license": "5625",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Darria Moore Bourgeois
• Joshua Bourgeois, M.ED., PLPC, NCC
• Julie Ann Brand-Vanveckhoven
• Raven Julia Brooks, LPC
• Brittney G. Brown, M.C.J., M.S., PLPC
• Carepath Transit LLC
• Heather Kathleen Carter, RBT
• Ivonne Castro, D.D.S.
• Catholic Charities
• Catholic Charities

• Oral and Maxillofacial Surgery (Dentist) in Belle Chasse, LA
• Providers in Belle Chasse, LA by specialty
• Oral and Maxillofacial Surgery (Dentist) in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2008; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.