NPIMap

Organization Active NPI

Lake Area Dentistry- Moss Bluff

  • Dental Clinic/Center
  • Lake Charles, LA
National Provider Identifier
1528535960
Registry record updated Oct 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
LAKE AREA DENTISTRY- MOSS BLUFF
Practice address
644 N Highway 171
Lake Charles, LA 70611-5348
Phone
(337) 855-2742
NPI assigned
Oct 24, 2018
Last updated
Oct 24, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2018

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

Authorized official

Name
Dr. Jeffery A Hennigan, DDS
Title
Owner
Phone
(337) 855-2742

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

644 N Highway 171
Lake Charles, LA 70611-5348

Mailing address

644 N Highway 171
Lake Charles, LA 70611-5348
Phone (337) 855-2742

National Provider Directory

National Provider Directory

Locations

644 N Highway 171
Lake Charles, LA 70611
Phone (337) 855-2742

NPI Registry JSON

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

{
    "created_epoch": "1540339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540339200000",
    "number": "1528535960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "644 N HIGHWAY 171",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706115348",
            "telephone_number": "337-855-2742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "644 N HIGHWAY 171",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706115348",
            "telephone_number": "337-855-2742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE AREA DENTISTRY- MOSS BLUFF",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-24",
        "last_updated": "2018-10-24",
        "status": "A",
        "authorized_official_last_name": "HENNIGAN",
        "authorized_official_first_name": "JEFFERY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "337-855-2742",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Charles, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.