Active NPI
Ellyn Marks O'Neal, DDS
- Dentist
- Baton Rouge, LA
National Provider Identifier
1265923635
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 6854
- Practice address
- 11424 Sullivan Rd
Baton Rouge, LA 70818-3615 - Phone
- (225) 715-9990
- NPI assigned
- May 22, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 6854 | LA | Primary |
Addresses
Primary practice location
11424 Sullivan Rd
Baton Rouge, LA 70818-3615
Mailing address
11424 Sullivan Rd Ste a
Baton Rouge, LA 70818-3615
Phone (225) 261-6645
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6854 | LA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1526947200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1562716800000",
"number": "1265923635",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11424 SULLIVAN RD STE A",
"city": "BATON ROUGE",
"state": "LA",
"postal_code": "708183615",
"telephone_number": "225-261-6645"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11424 SULLIVAN RD",
"city": "BATON ROUGE",
"state": "LA",
"postal_code": "708183615",
"telephone_number": "225-715-9990"
}
],
"practiceLocations": [],
"basic": {
"last_name": "O'NEAL",
"first_name": "ELLYN",
"middle_name": "MARKS",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-05-22",
"last_updated": "2019-07-10",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "LA",
"license": "6854",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Baton Rouge, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.