Active NPI
John M Gilmer Jr., D.D.S.
- Endodontics
- Shreveport, LA
National Provider Identifier
1346219581
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- 4694
- Practice address
- 275 Kayla St
Ste. 300
Shreveport, LA 71105-4257 - Phone
- (318) 865-5576
- Fax
- (318) 865-5529
- NPI assigned
- Mar 17, 2006
- 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 |
|---|---|---|---|---|
| Endodontics | 1223E0200X | 4694 | LA | Primary |
Addresses
Primary practice location
275 Kayla St
Ste. 300
Shreveport, LA 71105-4257
Mailing address
275 Kayla St
Ste. 300
Shreveport, LA 71105-4257
Phone (318) 865-5576
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
| License | State | Type | Specialty |
|---|---|---|---|
| 4694 | LA | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142553600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1346219581",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "275 KAYLA ST",
"address_2": "STE. 300",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711054257",
"telephone_number": "318-865-5576",
"fax_number": "318-865-5529"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "275 KAYLA ST",
"address_2": "STE. 300",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711054257",
"telephone_number": "318-865-5576",
"fax_number": "318-865-5529"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GILMER",
"first_name": "JOHN",
"middle_name": "M",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-17",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "LA",
"license": "4694",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shreveport, 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.