Active NPI
Rene Christopher Desselle, DDS
- Dentist
- Mansura, LA
National Provider Identifier
1285693788
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 4064
- Practice address
- 1837 Leglise St
Mansura, LA 71350 - Phone
- (318) 964-2300
- Fax
- (318) 964-2302
- NPI assigned
- Mar 22, 2006
- Last updated
- Jul 13, 2026
- Sex
- Male
- 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 | 4064 | LA | Primary |
Addresses
Primary practice location
1837 Leglise St
Mansura, LA 71350
Mailing address
1837 Leglise St
PO Box 250
Mansura, LA 71350
Phone (318) 964-2300
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1840645 | Medicaid | LA |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20151207002309 | LA | Order and Referring Only - Oral Surgery | 6305146713 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4064 | LA | MD | Pharmacy Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142985600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1285693788",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1837 LEGLISE ST",
"address_2": "PO BOX 250",
"city": "MANSURA",
"state": "LA",
"postal_code": "71350",
"telephone_number": "318-964-2300",
"fax_number": "318-964-2302"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1837 LEGLISE ST",
"city": "MANSURA",
"state": "LA",
"postal_code": "71350",
"telephone_number": "318-964-2300",
"fax_number": "318-964-2302"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DESSELLE",
"first_name": "RENE",
"middle_name": "CHRISTOPHER",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-22",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "LA",
"license": "4064",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1840645",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mansura, LA
- Christus Health Central Louisiana (Avoyelles Charter SBHC)
- Dekedria Cleveland-Turner, FNP
- Commcare Corporation (Riviere de Soleil Community Care Center)
- Micaela Rose Dauzat, MS, CF-SLP
- Tracy A Dauzat, RN
- DHH Oph Avoyelles Parish Health Unit
- Catherine Dixon, MOT/OTR
- Leah Domangue
- Julie Ann Ducote, FNP
- Austin T Dufrene, DPT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.