Active NPI
Amy Bordelon, D.D.S.
- Dentist
- Opelousas, LA
National Provider Identifier
1467801506
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 6666
- Practice address
- 1604 Kerr St Ste 104
Opelousas, LA 70570-7803 - Phone
- (337) 942-3221
- NPI assigned
- Jun 9, 2016
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 6666 | LA | Primary |
Addresses
Primary practice location
1604 Kerr St Ste 104
Opelousas, LA 70570-7803
Mailing address
1604 Kerr St Ste 104
Opelousas, LA 70570-7803
Phone (337) 942-3221
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 |
|---|---|---|---|
| 6666 | LA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1465430400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1465430400000",
"number": "1467801506",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1604 KERR ST STE 104",
"city": "OPELOUSAS",
"state": "LA",
"postal_code": "705707803",
"telephone_number": "337-942-3221"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1604 KERR ST STE 104",
"city": "OPELOUSAS",
"state": "LA",
"postal_code": "705707803",
"telephone_number": "337-942-3221"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BORDELON",
"first_name": "AMY",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-06-09",
"last_updated": "2016-06-09",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "LA",
"license": "6666",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Opelousas, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.