Individual provider Active NPI

Brynn L Leroux, D.D.S.

  • Pediatric Dentistry
  • Baton Rouge, LA
National Provider Identifier
1609071968
Registry record updated Mar 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
5808 Issued in LA
Practice address
4607 Sherwood Common Blvd
Ste 100
Baton Rouge, LA 70816-4295
Phone
(225) 924-6622
Fax
(225) 926-3384
NPI assigned
Jun 18, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 5808 LA Primary

Addresses

Primary practice location

4607 Sherwood Common Blvd
Ste 100
Baton Rouge, LA 70816-4295

Mailing address

PO Box 77758
Baton Rouge, LA 70879-7758
Phone (225) 924-6622

Other identifiers 1

IdentifierTypeStateIssuer
1858081MedicaidLA

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

LicenseStateTypeSpecialty
5808LAMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Associates in Pediatric Dentistry,LLC Pediatric Dentistry 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": "1182124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395100800000",
    "number": "1609071968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 77758",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708797758",
            "telephone_number": "225-924-6622",
            "fax_number": "225-926-3384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4607 SHERWOOD COMMON BLVD",
            "address_2": "STE 100",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708164295",
            "telephone_number": "225-924-6622",
            "fax_number": "225-926-3384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEROUX",
        "first_name": "BRYNN",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-18",
        "last_updated": "2014-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "LA",
            "license": "5808",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1858081",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.