Individual provider Active NPI

Iketria Byrd, D.D.S

  • Dentist
  • Metairie, LA
National Provider Identifier
1447785571
Registry record updated Jul 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
7471 Issued in LA
Practice address
5201 Veterans Memorial Blvd Unit a
Metairie, LA 70006-5122
Phone
(504) 273-7156
NPI assigned
Apr 26, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 10, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 32797 TX
Dentist 122300000X 25769 FL
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X D-0006885-C1 AL
Dentist 122300000X 7471 LA Primary

Addresses

Primary practice location

5201 Veterans Memorial Blvd Unit a
Metairie, LA 70006-5122

Mailing address

PO Box 6003
Monroe, LA 71211-6003
Phone (318) 537-4492

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
I20231109002692 LA Order and Referring Only - DentistPractitioner - Dentist 6709233927

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
25769FLMDDentist
32797TXMDDentist
D-0006885-C1ALMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Jacob Dent DDS Dentists of Metairie a Professional Corporation Dentist CurrentSince Jul 16, 2023 Accepting new patients
Complete Family Dental, P C Dentist PastSince Jun 1, 2021 Accepting new patients

Locations

5201 Veterans Memorial Blvd
#A
Metairie, LA 70006
Phone (504) 273-7156

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1493164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688947200000",
    "number": "1447785571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6003",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712116003",
            "telephone_number": "318-537-4492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5201 VETERANS MEMORIAL BLVD UNIT A",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700065122",
            "telephone_number": "504-273-7156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BYRD",
        "first_name": "IKETRIA",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-04-26",
        "last_updated": "2023-07-10",
        "certification_date": "2023-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "32797",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "25769",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "AL",
            "license": "D-0006885-C1",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "LA",
            "license": "7471",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Metairie, LA

Sources for this page

Verify at the official NPI Registry.