Kenneth R Dubois III, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

5997 Issued in LA

Practice address

1204 N Broad St.
New Orleans, LA 70119

Phone

(504) 821-2545

Fax

(504) 304-1446

NPI assigned

Mar 18, 2009

Last updated

Nov 8, 2016By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Hospitality Dentistry, LLC

  dba DBA Barbe Dental Clinic

  • General Practice Dentistry
  • New Orleans, LA
  • NPI 1164786885
  NPD (past) Authorized official

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

{
    "created_epoch": "1237334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478563200000",
    "number": "1285875344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1204 N BROAD ST.",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "70119",
            "telephone_number": "504-821-2545",
            "fax_number": "504-304-1446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1204 N BROAD ST.",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "70119",
            "telephone_number": "504-821-2545",
            "fax_number": "504-304-1446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUBOIS",
        "first_name": "KENNETH",
        "middle_name": "R",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-03-18",
        "last_updated": "2016-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "LA",
            "license": "5997",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1859974",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dryades YMCA
• Lingling Du, M.D.
• Joanna Lorraine Dubinsky, PA-C
• Anne Dubois, DDS
• Gordon A Dubois, DC
• Kenneth Richard Dubois II, DDS
• Marshall S Dubois
• Rebecca Dubois
• Jason N Dubos, DNP, CRNA
• Cynthia Dubose, RN

• General Practice Dentistry in New Orleans, LA
• Providers in New Orleans, LA by specialty
• General Practice Dentistry in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2016; 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.