Individual provider Active NPI

Daryl Marshall Westmoreland Sr., D.D.S.

  • General Practice Dentistry
  • Kentwood, LA
National Provider Identifier
1467670349
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
3481 Issued in LA
Practice address
68144 Highway 51
68144 Highway 51
Kentwood, LA 70444-0432
Phone
(985) 229-2192
NPI assigned
Apr 23, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

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 3481 LA Primary

Addresses

Primary practice location

68144 Highway 51
68144 Highway 51
Kentwood, LA 70444-0432

Mailing address

PO Box 432
PO Box 432
Kentwood, LA 70444-0432
Phone (985) 229-2192

Other identifiers 1

IdentifierTypeStateIssuer
1834815MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20260417002524 MS Order and Referring Only - DentistPractitioner - Dentist 1254807159

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3481LAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1467670349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 432",
            "address_2": "PO BOX 432",
            "city": "KENTWOOD",
            "state": "LA",
            "postal_code": "704440432",
            "telephone_number": "985-229-2192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "68144 HIGHWAY 51",
            "address_2": "68144 HIGHWAY 51",
            "city": "KENTWOOD",
            "state": "LA",
            "postal_code": "704440432",
            "telephone_number": "985-229-2192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WESTMORELAND",
        "first_name": "DARYL",
        "middle_name": "MARSHALL",
        "name_prefix": "Dr.",
        "name_suffix": "Sr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "LA",
            "license": "3481",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1834815",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kentwood, LA

Sources for this page

Verify at the official NPI Registry.