Active NPI
Conner Patrick Allison
- General Practice Dentistry
- Mandeville, LA
National Provider Identifier
1437846342
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 7411
- Practice address
- 2030 N Causeway Blvd
Mandeville, LA 70471-3116 - Phone
- (985) 626-3338
- NPI assigned
- Apr 20, 2023
- Last updated
- May 23, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 7411 | LA | Primary |
Addresses
Primary practice location
2030 N Causeway Blvd
Mandeville, LA 70471-3116
Mailing address
2030 N Causeway Blvd
Mandeville, LA 70471-3116
Phone (985) 276-0206
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7411 | LA | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northlake Dental LLC | General Practice | Current | Accepting new patients |
Locations
2030 N Causeway Blvd
Mandeville, LA 70471
Phone (985) 626-3338
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": "1681948800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1684800000000",
"number": "1437846342",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2030 N CAUSEWAY BLVD",
"city": "MANDEVILLE",
"state": "LA",
"postal_code": "704713116",
"telephone_number": "985-276-0206"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2030 N CAUSEWAY BLVD",
"city": "MANDEVILLE",
"state": "LA",
"postal_code": "704713116",
"telephone_number": "985-626-3338"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALLISON",
"first_name": "CONNER",
"middle_name": "PATRICK",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-04-20",
"last_updated": "2023-05-23",
"certification_date": "2023-05-23",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dentist, General Practice",
"state": "LA",
"license": "7411",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mandeville, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.