Active NPI
Dylan D Roberts, DDS
- Dentist
- Sicily Island, LA
National Provider Identifier
1578263711
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 7442
- Practice address
- 307 Chisum St
Sicily Island, LA 71368-4807 - Phone
- (318) 389-5727
- NPI assigned
- Mar 7, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Dentist | 122300000X | 7442 | LA | Primary |
Addresses
Primary practice location
307 Chisum St
Sicily Island, LA 71368-4807
Mailing address
620 Lamar Church Rd
Delhi, LA 71232-7299
Phone (318) 439-4512
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 |
|---|---|---|---|
| 7442 | LA | MD | Professional Counselor |
Interoperability endpoints
- dylan.roberts.p1@direct.rfcatahoulaparish1.nextgenshare.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1678147200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1684800000000",
"number": "1578263711",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "620 LAMAR CHURCH RD",
"city": "DELHI",
"state": "LA",
"postal_code": "712327299",
"telephone_number": "318-439-4512"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "307 CHISUM ST",
"city": "SICILY ISLAND",
"state": "LA",
"postal_code": "713684807",
"telephone_number": "318-389-5727"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTS",
"first_name": "DYLAN",
"middle_name": "D",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-03-07",
"last_updated": "2023-05-23",
"certification_date": "2023-05-23",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "LA",
"license": "7442",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sicily Island, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.