Individual provider Active NPI

Leith A Daigle, DDS

  • General Practice Dentistry
  • Slidell, LA
National Provider Identifier
1275680787
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
LA4059 Issued in LA
Practice address
4031 Pontchartrain Dr
Slidell, LA 70458-5135
Phone
(985) 641-7997
Fax
(985) 847-0604
NPI assigned
Jan 5, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X LA4059 LA Primary

Addresses

Primary practice location

4031 Pontchartrain Dr
Slidell, LA 70458-5135

Mailing address

4031 Pontchartrain Dr
Slidell, LA 70458-5135
Phone (985) 641-7997

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
I20160526001358 LA Order and Referring Only - DentistPractitioner - Dentist 9234429689

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4059LAMDProfessional Counselor
LA4059LAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1167955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1275680787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4031 PONTCHARTRAIN DR",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "704585135",
            "telephone_number": "985-641-7997",
            "fax_number": "985-847-0604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4031 PONTCHARTRAIN DR",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "704585135",
            "telephone_number": "985-641-7997",
            "fax_number": "985-847-0604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAIGLE",
        "first_name": "LEITH",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "LA",
            "license": "LA4059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Slidell, LA

Sources for this page

Verify at the official NPI Registry.