Individual provider Active NPI

Anna Brasher Moreau, D.D.S., M.S.

  • Pediatric Dentistry
  • Alexandria, LA
National Provider Identifier
1275546301
Registry record updated Mar 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
30-022105 Issued in OH
Practice address
1400 Metro Dr
Alexandria, LA 71301-3451
Phone
(318) 445-5471
Fax
(318) 445-5901
NPI assigned
Aug 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 30-022105 OH Primary

Addresses

Primary practice location

1400 Metro Dr
Alexandria, LA 71301-3451

Mailing address

1400 Metro Dr
Alexandria, LA 71301-3451
Phone (318) 445-5471

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
30-022105OHMDPediatric Dentist

NPI Registry JSON

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

{
    "created_epoch": "1155427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395273600000",
    "number": "1275546301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 METRO DR",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713013451",
            "telephone_number": "318-445-5471",
            "fax_number": "318-445-5901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 METRO DR",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713013451",
            "telephone_number": "318-445-5471",
            "fax_number": "318-445-5901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOREAU",
        "first_name": "ANNA",
        "middle_name": "BRASHER",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-13",
        "last_updated": "2014-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "OH",
            "license": "30-022105",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.