Individual provider Active NPI

Pamela Ann McCalister, D.D.S.

  • General Practice Dentistry
  • Natchitoches, LA
National Provider Identifier
1417013475
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
3567 Issued in LA
Practice address
104 Bienville St
Natchitoches, LA 71457-5014
Phone
(318) 352-6361
Fax
(318) 352-6336
NPI assigned
Dec 27, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 3567 LA Primary

Addresses

Primary practice location

104 Bienville St
Natchitoches, LA 71457-5014

Mailing address

128 Chinquapin PL
Natchitoches, LA 71457-6271
Phone (318) 357-9405

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
I20150918000702 LA Order and Referring Only - DentistPractitioner - Dentist 6204143563

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3567LAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417013475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 CHINQUAPIN PL",
            "city": "NATCHITOCHES",
            "state": "LA",
            "postal_code": "714576271",
            "telephone_number": "318-357-9405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 BIENVILLE ST",
            "city": "NATCHITOCHES",
            "state": "LA",
            "postal_code": "714575014",
            "telephone_number": "318-352-6361",
            "fax_number": "318-352-6336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCALISTER",
        "first_name": "PAMELA",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "LA",
            "license": "3567",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Natchitoches, LA

Sources for this page

Verify at the official NPI Registry.