Individual provider Active NPI

Kevin John Schellhaas, D.D.S.

  • General Practice Dentistry
  • Metairie, LA
National Provider Identifier
1568458560
Registry record updated Jun 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
4006 Issued in LA
Practice address
343 Metairie Rd
Metairie, LA 70005-4330
Phone
(504) 887-1272
Fax
(504) 835-1591
NPI assigned
Sep 25, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 27, 2020

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 4006 LA Primary

Addresses

Primary practice location

343 Metairie Rd
Metairie, LA 70005-4330

Mailing address

343 Metairie Rd
Metairie, LA 70005-4330
Phone (504) 887-1272

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20150624002924 TX Order and Referring Only - DentistPractitioner - Dentist 7315258894

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4006LAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1127606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593216000000",
    "number": "1568458560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "343 METAIRIE RD",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700054330",
            "telephone_number": "504-887-1272",
            "fax_number": "504-835-1591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "343 METAIRIE RD",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700054330",
            "telephone_number": "504-887-1272",
            "fax_number": "504-835-1591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHELLHAAS",
        "first_name": "KEVIN",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-25",
        "last_updated": "2020-06-27",
        "certification_date": "2020-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "LA",
            "license": "4006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Metairie, LA

Sources for this page

Verify at the official NPI Registry.