Active NPI
Michael Christopher Haydel, DDS
- Dentist
- Shreveport, LA
National Provider Identifier
1396167102
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 6362
- Practice address
- 910 Bert Kouns Industrial Loop
Shreveport, LA 71118-3410 - Phone
- (318) 686-7470
- NPI assigned
- Jan 13, 2014
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Dentist | 122300000X | 6362 | LA | Primary |
Addresses
Primary practice location
910 Bert Kouns Industrial Loop
Shreveport, LA 71118-3410
Mailing address
1711 Bayou Cir
Bossier City, LA 71112-4034
Phone (318) 464-0902
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 |
|---|---|---|---|
| 6362 | LA | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Benjamin a. Beach DDS and Ross H. Dies DDS Midcity, LLC | Past | Accepting new patients | |
| Ross H Dies DDS and J Cody Cowen DDS a Dental LLC | Past | 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.
-
- Dental Clinic/Center
- Shreveport, LA
- NPI 1528615887
-
- Clinic/Center
- Shreveport, LA
- NPI 1447360524
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1389571200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1389571200000",
"number": "1396167102",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1711 BAYOU CIR",
"city": "BOSSIER CITY",
"state": "LA",
"postal_code": "711124034",
"telephone_number": "318-464-0902"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "910 BERT KOUNS INDUSTRIAL LOOP",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711183410",
"telephone_number": "318-686-7470"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAYDEL",
"first_name": "MICHAEL",
"middle_name": "CHRISTOPHER",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-01-13",
"last_updated": "2014-01-13",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "LA",
"license": "6362",
"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 Jan 13, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.