Individual provider Active NPI

Elizabeth Jane Sherman Kleefisch, DDS, MSD

  • Pediatric Dentistry
  • Zachary, LA
National Provider Identifier
1366174385
Registry record updated Sep 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
0401418812 Issued in VA
Practice address
1515 Church St
Zachary, LA 70791-2748
Phone
(225) 654-7769
NPI assigned
Jun 28, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 26, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 0401418812 VA Primary
Pediatric Dentistry 1223P0221X 7317 LA

Addresses

Primary practice location

1515 Church St
Zachary, LA 70791-2748

Mailing address

1766 Avondale Dr
Baton Rouge, LA 70808-1310
Phone (225) 226-8561

Other practice location 1

580 City Center Blvd
Newport News, VA 23606-1880
Phone (757) 240-7511

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
7317LAMDPediatric Dentist
0401418812VAMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Parish Pediatric Dental Krewe Pediatric Dentistry CurrentSince Sep 28, 2025 Accepting new patients

Locations

1515 Church St
Zachary, LA 70791
Phone (225) 485-4122

Interoperability endpoints

  • Direct secure messaging: ekleefisch5341173@direct.casso.us.com

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": "1656374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758844800000",
    "number": "1366174385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1766 AVONDALE DR",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708081310",
            "telephone_number": "225-226-8561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 CHURCH ST",
            "city": "ZACHARY",
            "state": "LA",
            "postal_code": "707912748",
            "telephone_number": "225-654-7769"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "580 City Center Blvd",
            "address_purpose": "LOCATION",
            "city": "Newport News",
            "state": "VA",
            "postal_code": "236061880",
            "country_code": "US",
            "telephone_number": "757-240-7511",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KLEEFISCH",
        "first_name": "ELIZABETH",
        "middle_name": "JANE SHERMAN",
        "name_prefix": "Dr.",
        "credential": "DDS, MSD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-28",
        "last_updated": "2025-09-26",
        "certification_date": "2025-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "VA",
            "license": "0401418812",
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "LA",
            "license": "7317",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Zachary, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2025; 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.