Jean Philippe Vidrine, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

4320 Issued in LA

Practice address

717 W Lincoln Rd
Ville Platte, LA 70586-3147

Phone

(337) 363-2030

Fax

(337) 363-3611

NPI assigned

Feb 27, 2007

Last updated

Dec 15, 2015By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450137600000",
    "number": "1407983711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "717 W LINCOLN RD",
            "city": "VILLE PLATTE",
            "state": "LA",
            "postal_code": "705863147",
            "telephone_number": "337-363-2030",
            "fax_number": "337-363-3611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "717 W LINCOLN RD",
            "city": "VILLE PLATTE",
            "state": "LA",
            "postal_code": "705863147",
            "telephone_number": "337-363-2030",
            "fax_number": "337-363-3611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIDRINE",
        "first_name": "JEAN",
        "middle_name": "PHILIPPE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-27",
        "last_updated": "2015-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "LA",
            "license": "4320",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1843202",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brandi Lynn Vaughn
• Vidrine Community Clinic, LLC (Vidrine Community Clinic)
• Vidrine Rural Health Clinic LLC (Vidrine Rural Health Clinic)
• Lori Elizabeth Vidrine-Parks, M.D.
• David L Vidrine, P. T.
• Steven B Vidrine, MD
• Vigilant Healthcare-Southwest, LLC
• Ville Platte Medical Center
• Ville Platte Medical Center
• Ville Platte Pediatrics

• General Practice Dentistry in Ville Platte, LA
• Providers in Ville Platte, 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 Dec 15, 2015; 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.