Dale M. Trahan, DDS, LLC

Primary specialty

DentistTaxonomy code 122300000X

License

3209 Issued in LA

Practice address

102 Genevieve Dr
Lafayette, LA 70503-4811

Phone

(337) 981-6882

Fax

(337) 991-0542

NPI assigned

Dec 4, 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

Other identifiers 4

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

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.

• Dale M Trahan DDS LLC

  • Dentist
  • Lafayette, LA
  • NPI 1043393697
  NPD (past)
• Saloom Family Dentistry, LLC

  • Dental Clinic/Center
  • Lafayette, LA
  • NPI 1972368728
  NPD (past)

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

{
    "created_epoch": "1196726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196726400000",
    "number": "1235311929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 GENEVIEVE DR",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705034811",
            "telephone_number": "337-981-6882",
            "fax_number": "337-991-0542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 GENEVIEVE DR",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705034811",
            "telephone_number": "337-981-6882",
            "fax_number": "337-991-0542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAHAN",
        "first_name": "DALE",
        "middle_name": "M.",
        "credential": "DDS, LLC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-12-04",
        "last_updated": "2007-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "LA",
            "license": "3209",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSSBLUESHIELD OF TN",
            "identifier": "4065755",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1832090",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "427647",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSSBLUESHIELD OF MA",
            "identifier": "TRZQD354",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Traditions Hospice of Lafayette, LLC (Traditions Health)
• Trahan Mental Health Services LLC
• Angelle Trahan Saloom, DDS
• Christian Trahan
• Cydney Trahan
• Grace Trahan
• Jayme Trahan, M.D.
• Jessica Trahan, WHNP
• Judy Broussard Trahan, NP
• Katherine Alise Trahan, MS

• Dentist in Lafayette, LA
• Providers in Lafayette, LA by specialty
• Dentist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2007; 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.