Individual provider Active NPI

Kerry Thomas Plaisance Jr., DDS

  • General Practice Dentistry
  • River Ridge, LA
National Provider Identifier
1306990056
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5498 Issued in LA
Practice address
10154 Jefferson Hwy
River Ridge, LA 70123-2446
Phone
(504) 738-5171
Fax
(504) 738-7923
NPI assigned
Jan 22, 2007
Sex
Male
Sole proprietor
No

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 5498 LA Primary

Addresses

Primary practice location

10154 Jefferson Hwy
River Ridge, LA 70123-2446

Mailing address

10154 Jefferson Hwy
River Ridge, LA 70123-2446
Phone (504) 738-5171

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
5498LAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Dejong and Plaisance Dentistry Partnership General Practice Past Accepting new patients
Plaisance and Bostick Dental Partnership LLC PastSince Dec 8, 2024 Accepting new patients

Organizations & group practices 2

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": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306990056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10154 JEFFERSON HWY",
            "city": "RIVER RIDGE",
            "state": "LA",
            "postal_code": "701232446",
            "telephone_number": "504-738-5171",
            "fax_number": "504-738-7923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10154 JEFFERSON HWY",
            "city": "RIVER RIDGE",
            "state": "LA",
            "postal_code": "701232446",
            "telephone_number": "504-738-5171",
            "fax_number": "504-738-7923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PLAISANCE",
        "first_name": "KERRY",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "LA",
            "license": "5498",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in River Ridge, LA

Sources for this page

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