C.M. Lester DDS a Professional Dental Corp

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

1956 Issued in LA

Legal business name

C.M. LESTER DDS A PROFESSIONAL DENTAL CORP

Practice address

4034 Hollywood Ave
Shreveport, LA 71109-7938

Phone

(318) 631-0270

Fax

(318) 631-0233

NPI assigned

Feb 2, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Charley Marion Lester Jr., D.D.S.

Title

President

Phone

(318) 631-0270

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1328140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328140800000",
    "number": "1356613681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4034 HOLLYWOOD AVE",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711097938",
            "telephone_number": "318-631-0270",
            "fax_number": "318-631-0233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4034 HOLLYWOOD AVE",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711097938",
            "telephone_number": "318-631-0270",
            "fax_number": "318-631-0233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "C.M. LESTER DDS A PROFESSIONAL DENTAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-02",
        "last_updated": "2012-02-02",
        "status": "A",
        "authorized_official_last_name": "LESTER",
        "authorized_official_first_name": "CHARLEY",
        "authorized_official_middle_name": "MARION",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "318-631-0270",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "LA",
            "license": "1956",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1819565",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laxman Byreddi
• Kayla Renae Byrne, D.D.S.
• Marshall J. Byun-Andersen, MD
• C & B Transport 9 LLC
• C. H. Wilkinson Physician Network (Christus Medical Group Ashley Ridge)
• C&C Sitting Agency LLC
• Caddo Behavioral Health Services (CBH)
• Caddo Council on Aging, Inc.
• Caddo Fire District No 1
• Caddo Medical Transportation Incorporated

• Dental Clinic/Center in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Dental Clinic/Center in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2012; 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.