Active NPI
Bryant Louis Bourgeois, DDS
- General Practice Dentistry
- Gonzales, LA
National Provider Identifier
1407461981
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 7136
- Practice address
- 13317 N Burnside
Gonzales, LA 70737 - Phone
- (225) 644-4000
- NPI assigned
- Sep 11, 2020
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 7136 | LA | Primary |
Addresses
Primary practice location
13317 N Burnside
Gonzales, LA 70737
Mailing address
8727 Scarlett Dr
Baton Rouge, LA 70806-8529
Phone (225) 776-7675
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 |
|---|---|---|---|
| 7136 | LA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1599782400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1599782400000",
"number": "1407461981",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8727 SCARLETT DR",
"city": "BATON ROUGE",
"state": "LA",
"postal_code": "708068529",
"telephone_number": "225-776-7675"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13317 N BURNSIDE",
"city": "GONZALES",
"state": "LA",
"postal_code": "70737",
"telephone_number": "225-644-4000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOURGEOIS",
"first_name": "BRYANT",
"middle_name": "LOUIS",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-09-11",
"last_updated": "2020-09-11",
"certification_date": "2020-09-10",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "LA",
"license": "7136",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gonzales, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.