Individual provider Active NPI

Laten Edwards Barham, DDS

  • Dentist
  • Monroe, LA
National Provider Identifier
1306404363
Registry record updated Jun 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
6982 Issued in LA
Practice address
4351 Pecanland Mall Dr
Monroe, LA 71203-7014
Phone
(318) 582-4459
NPI assigned
Jun 4, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 6982 LA Primary

Addresses

Primary practice location

4351 Pecanland Mall Dr
Monroe, LA 71203-7014

Mailing address

38 Lane Ranch Rd
Rayville, LA 71269-6570
Phone (318) 680-1373

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
6982LAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1559606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559606400000",
    "number": "1306404363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38 LANE RANCH RD",
            "city": "RAYVILLE",
            "state": "LA",
            "postal_code": "712696570",
            "telephone_number": "318-680-1373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4351 PECANLAND MALL DR",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712037014",
            "telephone_number": "318-582-4459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARHAM",
        "first_name": "LATEN",
        "middle_name": "EDWARDS",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-04",
        "last_updated": "2019-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "LA",
            "license": "6982",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2019; 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.