Individual provider Active NPI

Bonnie Muro Ust, D.D.S.

  • General Practice Dentistry
  • Metairie, LA
National Provider Identifier
1346651817
Registry record updated May 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
6455 Issued in LA
Practice address
3939 Houma Blvd
Building 3 Suite 11
Metairie, LA 70006-2931
Phone
(504) 460-3419
NPI assigned
May 18, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2014

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 6455 LA Primary

Addresses

Primary practice location

3939 Houma Blvd
Building 3 Suite 11
Metairie, LA 70006-2931

Mailing address

1029 Nursery Ave
Metairie, LA 70005-2321
Phone (504) 460-3419

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160216000612 LA Order and Referring Only - DentistPractitioner - Dentist 2365746153

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6455LAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Ustdds, Inc. General Practice Past Accepting new patients

Organizations & group practices 1

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": "1400371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400371200000",
    "number": "1346651817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1029 NURSERY AVE",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700052321",
            "telephone_number": "504-460-3419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3939 HOUMA BLVD",
            "address_2": "BUILDING 3 SUITE 11",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700062931",
            "telephone_number": "504-460-3419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UST",
        "first_name": "BONNIE",
        "middle_name": "MURO",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-18",
        "last_updated": "2014-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "LA",
            "license": "6455",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Metairie, LA

Sources for this page

Verify at the official NPI Registry.