Chad Schiele Vaught, DDS

Individual provider Active NPI Dentist · Folsom, LA

NPI 1497964266 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1497964266
Entity type
Individual (NPI type 1)
Primary specialty
Dentist 122300000X
License
5828 (LA)
Practice address
78361 Highway 25
Folsom, LA 70437-3320
Phone
(985) 796-9345
NPI assigned
May 21, 2007
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20160205000442 LA Order and Referring Only - Dentist
Practitioner - Dentist
2062716483

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
5828LAMDDentist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 5828 LA Yes

Addresses

Primary practice location

78361 Highway 25
Folsom, LA 70437-3320

Mailing address

78361 Highway 25
Folsom, LA 70437-3320
Phone (985) 796-9345

Other providers in Folsom, LA

All providers in Folsom, LA · Dentist in Louisiana

Sources for this page

Verify at the official NPI Registry.