NPIMap

Individual provider Active NPI

Charles Clay Couvillon, DDS

  • General Practice Dentistry
  • St Francisville, LA
National Provider Identifier
1306039581
Registry record updated Aug 22, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5558 Issued in LA
Practice address
5436 Commerce
St Francisville, LA 70775
Phone
(225) 635-4422
Fax
(225) 635-2171
NPI assigned
Aug 22, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 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 5558 LA Primary

Addresses

Primary practice location

5436 Commerce
St Francisville, LA 70775

Mailing address

PO Box 2880
5436 Commerce
Saint Francisville, LA 70775-2880
Phone (225) 635-4422

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

LicenseStateTypeSpecialty
5558LAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Audubon Urgent Dental General Practice Current Accepting new patients
Sullivan Dental Center Past Accepting new patients
SSC Dental Center LLC General Practice Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1187740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187740800000",
    "number": "1306039581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2880",
            "address_2": "5436 COMMERCE",
            "city": "SAINT FRANCISVILLE",
            "state": "LA",
            "postal_code": "707752880",
            "telephone_number": "225-635-4422",
            "fax_number": "225-635-2171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5436 COMMERCE",
            "city": "ST FRANCISVILLE",
            "state": "LA",
            "postal_code": "70775",
            "telephone_number": "225-635-4422",
            "fax_number": "225-635-2171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COUVILLON",
        "first_name": "CHARLES",
        "middle_name": "CLAY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-22",
        "last_updated": "2007-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "LA",
            "license": "5558",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Francisville, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2007; 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.