Mary Seale Churchman, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

5662 Issued in LA

Practice address

3632 Common St
Lake Charles, LA 70607-1744

Phone

(337) 478-4022

Fax

(337) 478-4017

NPI assigned

Dec 21, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1598829848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3632 COMMON ST",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "70607",
            "telephone_number": "337-478-4022",
            "fax_number": "337-478-4017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3632 COMMON ST",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706071744",
            "telephone_number": "337-478-4022",
            "fax_number": "337-478-4017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHURCHMAN",
        "first_name": "MARY",
        "middle_name": "SEALE",
        "name_prefix": "Mrs.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "LA",
            "license": "5662",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• CHI Fei Chung, MD
• Lisa Marie Church, NP
• Churchman Family Dentistry
• Carl William Churchman Jr., DDS
• James Richard Churchman, D.D.S.
• Sloane Elizabeth Churchman, MS, RD, LDN
• Cathy Marie Clanton, COUNSELOR IN TRAININ
• Clark a Gunderson MD AMC
• Courtney Clark, APRN, FNP-C
• Dennis Wayne Clark, CRNA

• General Practice Dentistry in Lake Charles, LA
• Providers in Lake Charles, LA by specialty
• General Practice Dentistry in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.