Individual provider Active NPI

Robert Joseph Edwards, DDS

  • General Practice Dentistry
  • Baton Rouge, LA
National Provider Identifier
1588890446
Registry record updated Jan 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5963 Issued in LA
Practice address
5188 Highland Rd
Baton Rouge, LA 70808-6527
Phone
(225) 766-8107
Fax
(225) 766-2382
NPI assigned
Jun 5, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 10, 2022

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 5963 LA Primary

Addresses

Primary practice location

5188 Highland Rd
Baton Rouge, LA 70808-6527

Mailing address

5188 Highland Rd
Baton Rouge, LA 70808-6527
Phone (225) 766-8107

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20160324000763 LA Order and Referring Only - DentistPractitioner - Dentist 5294032934

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Edwards Premier Dental Care and Implant Center General Practice CurrentSince Jan 17, 2022 Accepting new patients

Locations

17240 Jefferson Hwy
Baton Rouge, LA 70817
Phone (225) 336-8478

5188 Highland Rd
Baton Rouge, LA 70808
Phone (225) 766-8107

Interoperability endpoints

  • Direct secure messaging: redwards5300520@direct.casso.us.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1244160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641772800000",
    "number": "1588890446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5188 HIGHLAND RD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708086527",
            "telephone_number": "225-766-8107",
            "fax_number": "225-766-2382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5188 HIGHLAND RD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708086527",
            "telephone_number": "225-766-8107",
            "fax_number": "225-766-2382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "ROBERT",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-06-05",
        "last_updated": "2022-01-10",
        "certification_date": "2022-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "LA",
            "license": "5963",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

Verify at the official NPI Registry.