Individual provider Active NPI

Calvin Gregory Bessonet III, DDS

  • Dentist
  • Geismar, LA
National Provider Identifier
1396751624
Registry record updated Jan 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
5514 Issued in LA
Practice address
13053 Highway 73
Ste a
Geismar, LA 70734-3021
Phone
(225) 673-6910
Fax
(225) 677-8906
NPI assigned
Jul 31, 2006
Last updated
Jan 24, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 5514 LA Primary

Addresses

Primary practice location

13053 Highway 73
Ste a
Geismar, LA 70734-3021

Mailing address

13053 Highway 73
Ste a
Geismar, LA 70734-3021
Phone (504) 905-9887

Other identifiers 1

IdentifierTypeStateIssuer
1855146MedicaidLA

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
I20150604000614 LA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 5092036921

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5514LAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Ascension Premier Dental, LLC PastSince Mar 22, 2020 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485216000000",
    "number": "1396751624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13053 HIGHWAY 73",
            "address_2": "STE A",
            "city": "GEISMAR",
            "state": "LA",
            "postal_code": "707343021",
            "telephone_number": "504-905-9887",
            "fax_number": "225-677-8906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13053 HIGHWAY 73",
            "address_2": "STE A",
            "city": "GEISMAR",
            "state": "LA",
            "postal_code": "707343021",
            "telephone_number": "225-673-6910",
            "fax_number": "225-677-8906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BESSONET",
        "first_name": "CALVIN",
        "middle_name": "GREGORY",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2017-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "LA",
            "license": "5514",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1855146",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Geismar, LA

Sources for this page

Verify at the official NPI Registry.