Individual provider Active NPI

Bryan S. Pearson, DDS,MS

  • Periodontics
  • Lafayette, LA
National Provider Identifier
1598880239
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
3322 Issued in LA
Practice address
3839 W Congress St
Suite D
Lafayette, LA 70506-6000
Phone
(337) 989-0267
Fax
(337) 989-9030
NPI assigned
Mar 20, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 3322 LA Primary

Addresses

Primary practice location

3839 W Congress St
Suite D
Lafayette, LA 70506-6000

Mailing address

3839 W Congress St
Suite D
Lafayette, LA 70506-6000
Phone (337) 989-0267

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
I20160425002391 LA Order and Referring Only - DentistPractitioner - Dentist 2860791837

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
3322LAMDRadiologic Technologist

Practice roles

OrganizationSpecialtyStatusNew patients
Periodontics Associates, LLP Periodontics Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1598880239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3839 W CONGRESS ST",
            "address_2": "SUITE D",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705066000",
            "telephone_number": "337-989-0267",
            "fax_number": "337-989-9030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3839 W CONGRESS ST",
            "address_2": "SUITE D",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705066000",
            "telephone_number": "337-989-0267",
            "fax_number": "337-989-9030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEARSON",
        "first_name": "BRYAN",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "DDS,MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "LA",
            "license": "3322",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, LA

Sources for this page

Verify at the official NPI Registry.