Individual provider Active NPI

Dwayne Kincade, DDS

  • Dentist
  • New Iberia, LA
National Provider Identifier
1437196235
Registry record updated Oct 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
4791 Issued in LA
Practice address
806 Jefferson Ter
New Iberia, LA 70560-5727
Phone
(337) 365-4945
Fax
(337) 376-6860
NPI assigned
Jun 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 4791 LA Primary

Addresses

Primary practice location

806 Jefferson Ter
New Iberia, LA 70560-5727

Mailing address

806 Jefferson Ter
New Iberia, LA 70560-5727
Phone (337) 365-4945

Other practice location 1

567 Walker St
Merryville, LA 70653-3040
Phone (337) 825-1728

Other practice location 2

1050 N Robinson St
Many, LA 71449-3536
Phone (318) 256-8150

Other practice location 3

1004 Surrey St
Lafayette, LA 70501-6143
Phone (337) 456-6768

Other practice location 4

317 Dernier St
Saint Martinville, LA 70582-3809
Phone (337) 342-2566

Other practice location 5

1009 Charity St
Abbeville, LA 70510-5302
Phone (337) 893-3443

Other identifiers 1

IdentifierTypeStateIssuer
1847917MedicaidLA

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
I20160315002541 LA Order and Referring Only - DentistPractitioner - Dentist 8820394968

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4791LAMDProfessional Counselor

Interoperability endpoints

  • Direct secure messaging: dwayne.kincade@icchc.eclinicaldirectplus.com

NPI Registry JSON

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

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571184000000",
    "number": "1437196235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "806 JEFFERSON TER",
            "city": "NEW IBERIA",
            "state": "LA",
            "postal_code": "705605727",
            "telephone_number": "337-365-4945",
            "fax_number": "337-376-6860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "806 JEFFERSON TER",
            "city": "NEW IBERIA",
            "state": "LA",
            "postal_code": "705605727",
            "telephone_number": "337-365-4945",
            "fax_number": "337-376-6860"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "567 Walker St",
            "address_purpose": "LOCATION",
            "city": "Merryville",
            "state": "LA",
            "postal_code": "706533040",
            "country_code": "US",
            "telephone_number": "337-825-1728",
            "fax_number": "337-825-1229",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1050 N Robinson St",
            "address_purpose": "LOCATION",
            "city": "Many",
            "state": "LA",
            "postal_code": "714493536",
            "country_code": "US",
            "telephone_number": "318-256-8150",
            "fax_number": "318-256-8136",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1004 Surrey St",
            "address_purpose": "LOCATION",
            "city": "Lafayette",
            "state": "LA",
            "postal_code": "705016143",
            "country_code": "US",
            "telephone_number": "337-456-6768",
            "fax_number": "337-456-8690",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "317 Dernier St",
            "address_purpose": "LOCATION",
            "city": "Saint Martinville",
            "state": "LA",
            "postal_code": "705823809",
            "country_code": "US",
            "telephone_number": "337-342-2566",
            "fax_number": "337-342-2392",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1009 Charity St",
            "address_purpose": "LOCATION",
            "city": "Abbeville",
            "state": "LA",
            "postal_code": "705105302",
            "country_code": "US",
            "telephone_number": "337-893-3443",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KINCADE",
        "first_name": "DWAYNE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-01",
        "last_updated": "2019-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "LA",
            "license": "4791",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1847917",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Iberia, LA

Sources for this page

Verify at the official NPI Registry.