Pamela Ponce de Leon Daigle, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

7060 Issued in LA

Practice address

2130 Gause Blvd W
Slidell, LA 70460-4118

Phone

(985) 326-1711

NPI assigned

Jun 9, 2020

Last updated

Feb 19, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Pamela Daigle DDS LLC

  dba Off The Trace Dental

  • Dental Clinic/Center
  • Slidell, LA
  • NPI 1952059644
  NPD Authorized official

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

{
    "created_epoch": "1591660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676764800000",
    "number": "1407471055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8645",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "704708645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2130 GAUSE BLVD W",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "704604118",
            "telephone_number": "985-326-1711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAIGLE",
        "first_name": "PAMELA",
        "middle_name": "PONCE DE LEON",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-09",
        "last_updated": "2023-02-19",
        "certification_date": "2023-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "LA",
            "license": "7060",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William H Dabdoub, DPM
• Carmen N. Daddona, SA-C
• Mahmoud Daftary, MD
• Michael Sonny Dai, DDS
• Leith A Daigle, DDS
• Jeanne Bienvenu Dakin, CPNP
• Dale Moore Cpa LLC
• Dennis Maestri Dale, MD
• Derrinisha Dales
• Kimberly Schneider Dalmau, M.D.

• General Practice Dentistry in Slidell, LA
• Providers in Slidell, LA by specialty
• General Practice Dentistry in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.