Individual provider Active NPI

Karlnelius Duhon, DDS

  • Dentist
  • Lake Charles, LA
National Provider Identifier
1245644731
Registry record updated Oct 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
6483 Issued in LA
Practice address
3829 Ryan St Ste 200
Lake Charles, LA 70605-2815
Phone
(337) 221-0072
Fax
(337) 221-0072
NPI assigned
Jun 12, 2014
Last updated
Oct 7, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 7, 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 6483 LA Primary

Addresses

Primary practice location

3829 Ryan St Ste 200
Lake Charles, LA 70605-2815

Mailing address

3829 Ryan St Ste 200
Lake Charles, LA 70605-2815
Phone (337) 221-0072

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
I20160315001641 LA Order and Referring Only - DentistPractitioner - Dentist 7911203120

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6483LAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Karlnelius Duhon DDS LLC CurrentSince Oct 9, 2022 Accepting new patients

Locations

3829 Ryan St
Ste 200
Lake Charles, LA 70605
Phone (337) 221-0072

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1402531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665100800000",
    "number": "1245644731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3829 RYAN ST STE 200",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706052815",
            "telephone_number": "337-221-0072",
            "fax_number": "337-221-0072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3829 RYAN ST STE 200",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706052815",
            "telephone_number": "337-221-0072",
            "fax_number": "337-221-0072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUHON",
        "first_name": "KARLNELIUS",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-06-12",
        "last_updated": "2022-10-07",
        "certification_date": "2022-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "LA",
            "license": "6483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Charles, LA

Sources for this page

Verify at the official NPI Registry.