Individual provider Active NPI

Henry Lance Donald

  • Endodontics
  • West Monroe, LA
National Provider Identifier
1417026279
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
4776 Issued in LA
Practice address
106 Professional Dr
West Monroe, LA 71291-5332
Phone
(318) 324-0080
NPI assigned
Nov 7, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
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
Endodontics 1223E0200X 4776 LA Primary

Addresses

Primary practice location

106 Professional Dr
West Monroe, LA 71291-5332

Mailing address

106 Professional Dr
West Monroe, LA 71291-5332
Phone (318) 324-0080

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
I20150203001882 LA Order and Referring Only - DentistPractitioner - Dentist 0345565826

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4776LAMDDental Hygienist

Practice roles

OrganizationSpecialtyStatusNew patients
H. Lance Donald DDS Endodontics Past Accepting new patients

Organizations & group practices 1

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": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417026279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 PROFESSIONAL DR",
            "city": "WEST MONROE",
            "state": "LA",
            "postal_code": "712915332",
            "telephone_number": "318-324-0080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 PROFESSIONAL DR",
            "city": "WEST MONROE",
            "state": "LA",
            "postal_code": "712915332",
            "telephone_number": "318-324-0080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONALD",
        "first_name": "HENRY",
        "middle_name": "LANCE",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "LA",
            "license": "4776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Monroe, LA

Sources for this page

Verify at the official NPI Registry.